MEDICARE: DR. SCOTT MARSHALL SEGAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	148466	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60148466	OTHER	NY	STATE EDUCATION DEPT. NUM

General Provider Information

NPI Number	:	1073557245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT MARSHALL SEGAN M.D.

Provider Business Mailing Address
First Line	:	ST. BARNABAS HOSPITAL
Second Line	:	4422 THIRD AVE.
City	:	BRONX
State	:	NY
Zip	:	10457-2594
Country	:	US
Telephone Number	:	718-960-6130
Fax Number	:

Provider Business Practice Location Address
First Line	:	ST. BARNABAS HOSPITAL
Second Line	:	4422 THIRD AVE.
City	:	BRONX
State	:	NY
Zip	:	10457-2594
Country	:	US
Telephone Number	:	718-960-6130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/08/2007

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