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NPI Code Detail

MEDICARE: MS. MARILYN R SEGEL LCSW

MEDICARE: MS. MARILYN R SEGEL LCSW
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
11041C0700XClinical Social WorkerR0217001NY

General Provider Information

NPI Number : 1114083417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARILYN R SEGEL LCSW
Provider Business Mailing Address
First Line : 135 PROSPECT PARK SW
Second Line : D1
City : BROOKLYN
State : NY
Zip : 11218
Country : US
Telephone Number : 718-768-4142
Fax Number : 718-768-4142
Provider Business Practice Location Address
First Line : 11515 SUTPHIN BLVD
Second Line :
City : JAMAICA
State : NY
Zip : 11434-1020
Country : US
Telephone Number : 718-659-4000
Fax Number : 718-659-1405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 09/17/2013

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