Provider Demographics
NPI:1093729303
Name:SEGAL, INARA K (PHD)
Entity Type:Individual
Prefix:DR
First Name:INARA
Middle Name:K
Last Name:SEGAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 ROUTE 23 NORTH
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2002
Mailing Address - Country:US
Mailing Address - Phone:973-492-8700
Mailing Address - Fax:973-492-7670
Practice Address - Street 1:1250 ROUTE 23 NORTH
Practice Address - Street 2:SUITE 5
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-2002
Practice Address - Country:US
Practice Address - Phone:973-492-8700
Practice Address - Fax:973-492-7670
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00171300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJIP030586OtherMAGELLAN
NJ105663OtherMHN
NJ35SI00171300OtherPSYCHOLOGIST LICENSE #
IS130OtherOXFORD ID
NJR33726Medicare UPIN
NJ702918Medicare ID - Type Unspecified