Provider Demographics
NPI:1376650085
Name:SEGRETO, FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:SEGRETO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3549
Mailing Address - Country:US
Mailing Address - Phone:732-270-6222
Mailing Address - Fax:732-270-8447
Practice Address - Street 1:882 BAY AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3549
Practice Address - Country:US
Practice Address - Phone:732-270-6222
Practice Address - Fax:732-270-8447
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00346700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSE567910Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NJT88184Medicare UPIN