Healthcare Provider Details

I. General information

NPI: 1689638173
Provider Name (Legal Business Name): MARGERY E SEGAL PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 NEW YORK AVE
HUNTINGTON NY
11743-4240
US

IV. Provider business mailing address

44 ASTER ST
GREENLAWN NY
11740-3016
US

V. Phone/Fax

Practice location:
  • Phone: 631-424-0010
  • Fax:
Mailing address:
  • Phone: 631-262-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number016401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: