MEDICARE: REUBEN SEGAL RPH

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	183500000X	Pharmacist	035055	NY

General Provider Information

NPI Number	:	1710202403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REUBEN SEGAL RPH

Provider Business Mailing Address
First Line	:	756 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-5511
Country	:	US
Telephone Number	:	718-237-4526
Fax Number	:	718-237-0348

Provider Business Practice Location Address
First Line	:	756 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-5511
Country	:	US
Telephone Number	:	718-237-4526
Fax Number	:	718-237-0348

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

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	12/08/2022

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