Provider Demographics
NPI:1235211178
Name:SEGAL, ALEXANDER LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:LEE
Last Name:SEGAL
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 1:29 AZUCENA ST. URB RIO PIEDRAS VALLEY
Mailing Address - Street 2:URB. RIO PIEDRAS VALLEY
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-413-0297
Mailing Address - Fax:787-753-7592
Practice Address - Street 1:239 AVE. ARTERIAL HOSTOS, CAPITAL CENTER
Practice Address - Street 2:SUITE 205
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-413-0297
Practice Address - Fax:787-753-7527
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15692207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15692OtherSTATE MEDICAL LICENCE
PR0023250Medicare PIN