Provider Demographics
NPI:1346001187
Name:SEGRETI, MARTHA (DPT)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:SEGRETI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14808 NATIVE DANCER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3707
Mailing Address - Country:US
Mailing Address - Phone:301-922-3303
Mailing Address - Fax:
Practice Address - Street 1:150 S WASHINGTON ST STE 203
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-2921
Practice Address - Country:US
Practice Address - Phone:301-922-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052104332251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics