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General NPI Number Information
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NPI Number | 1043235997
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Entity Type | Organization
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Legal Business Name | PEDRO SEGARRA JR
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 3751 75TH ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6422
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Country | US
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Telephone | 718-672-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 3751 75TH ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6422
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Country | US
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Telephone | 718-672-4449
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PEDRO SEGARRA
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Credential | MD
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Telephone | 718-672-4449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 162095
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License Number State | NY
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