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General NPI Number Information
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NPI Number | 1346001187
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Entity Type | Individual
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Provider Name | MARTHA SEGRETI DPT
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Gender | Female
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 150 S WASHINGTON ST STE 203
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City | FALLS CHURCH
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State | VA
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Zip | 22046-2921
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Country | US
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Telephone | 301-922-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 14808 NATIVE DANCER RD
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-3707
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Country | US
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Telephone | 301-922-3303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 2305210433
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License Number State | VA
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