MEDICARE: KIARA SEGAL

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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1497399448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA SEGAL

Provider Business Mailing Address
First Line	:	99 SANDY VALLEY RD
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-5808
Country	:	US
Telephone Number	:	617-947-0539
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 SANDY VALLEY RD
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-5808
Country	:	US
Telephone Number	:	617-947-0539
Fax Number	:

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

Provider Enumeration Date	:	11/03/2019
Last Update Date	:	11/03/2019

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Directions to “ KIARA SEGAL ” Practice Location

Language	Start Address	Practice Location

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