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NPI Code Detail

MEDICARE: MRS. TRACY SEGAL OTR/L

MEDICARE: MRS. TRACY SEGAL OTR/L
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
1225XP0019XPhysical Rehabilitation Occupational TherapistOC003876LPA

General Provider Information

NPI Number : 1598024614
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACY SEGAL OTR/L
Provider Business Mailing Address
First Line : 1609 BRITTANY DR
Second Line :
City : MAPLE GLEN
State : PA
Zip : 19002-3152
Country : US
Telephone Number : 215-540-8584
Fax Number :
Provider Business Practice Location Address
First Line : 1609 BRITTANY DR
Second Line :
City : MAPLE GLEN
State : PA
Zip : 19002-3152
Country : US
Telephone Number : 215-540-8584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2012
Last Update Date : 05/09/2012

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