MEDICARE: JUANITA SEGARRA

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	237700000X	Hearing Instrument Specialist	F03317	PA

General Provider Information

NPI Number	:	1356741235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUANITA SEGARRA

Provider Business Mailing Address
First Line	:	219 WEST GROVE STREET, LOWER LEVEL
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-9348
Country	:	US
Telephone Number	:	570-319-0244
Fax Number	:	570-338-4480

Provider Business Practice Location Address
First Line	:	219 W GROVE ST LOWR LEVEL
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-2023
Country	:	US
Telephone Number	:	570-319-0244
Fax Number	:	570-338-4480

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

Provider Enumeration Date	:	08/28/2014
Last Update Date	:	01/27/2017

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Directions to “ JUANITA SEGARRA ” Practice Location

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