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NPI Code Detail

MEDICARE: ORLANDO SEGARRA FNP

MEDICARE: ORLANDO SEGARRA FNP
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
1363LF0000XFamily Nurse Practitioner624148TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1123617102OTHERTXFC PROVIDER NUMBER
2624148OTHERTXNURSING LICENSE

General Provider Information

NPI Number : 1194785881
Entity Type Code : Individual
Provider Name (Legal Business Name) : ORLANDO SEGARRA FNP
Provider Business Mailing Address
First Line : 22 PLUTO LN
Second Line :
City : MODENA
State : NY
Zip : 12548-5145
Country : US
Telephone Number : 806-570-8013
Fax Number : 806-737-4865
Provider Business Practice Location Address
First Line : 41 CASTLE POINT RD
Second Line :
City : WAPPINGERS FALLS
State : NY
Zip : 12590-7004
Country : US
Telephone Number : 845-831-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2006
Last Update Date : 06/09/2016

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