Provider Demographics
NPI:1306824982
Name:SEGARRA, NEIRA I (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIRA
Middle Name:I
Last Name:SEGARRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:500 PASEO MONACO
Mailing Address - Street 2:APT 41
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9773
Mailing Address - Country:US
Mailing Address - Phone:787-315-8180
Mailing Address - Fax:787-995-0283
Practice Address - Street 1:STREET 2 G-14
Practice Address - Street 2:VILLA RICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-4402
Practice Address - Fax:787-995-0283
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15867208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI65018Medicare UPIN
PR0025018Medicare PIN