Provider Demographics
NPI:1073557245
Name:SEGAN, SCOTT MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MARSHALL
Last Name:SEGAN
Suffix:
Gender:M
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:ST. BARNABAS HOSPITAL
Mailing Address - Street 2:4422 THIRD AVE.
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2594
Mailing Address - Country:US
Mailing Address - Phone:718-960-6130
Mailing Address - Fax:
Practice Address - Street 1:ST. BARNABAS HOSPITAL
Practice Address - Street 2:4422 THIRD AVE.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2594
Practice Address - Country:US
Practice Address - Phone:718-960-6130
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1484662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY60148466OtherSTATE EDUCATION DEPT. NUM
NYE98507Medicare UPIN
NY60148466OtherSTATE EDUCATION DEPT. NUM