Provider Demographics
NPI:1073522009
Name:SEGARRA ROBERTS, GALE (MD)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:
Last Name:SEGARRA ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SOUTH BEDFORD RD
Mailing Address - Street 2:BEDFORD ANESTHESIA PLLC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-244-6787
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:34 SOUTH BEDFORD RD
Practice Address - Street 2:BEDFORD ANESTHESIA PLLC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3408
Practice Address - Country:US
Practice Address - Phone:914-244-6787
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228940207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDB5589OtherGROUP MEDICARE RAILROAD
NYDB5589OtherGROUP MEDICARE RAILROAD
NY1681T1Medicare PIN
NYI58154Medicare UPIN
NY1681TLM261Medicare PIN