Provider Demographics
NPI:1427227347
Name:BRUCE A. SEGAL MD PA
Entity Type:Organization
Organization Name:BRUCE A. SEGAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KURBART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-498-3664
Mailing Address - Street 1:5258 LINTON BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6540
Mailing Address - Country:US
Mailing Address - Phone:561-498-3664
Mailing Address - Fax:
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6540
Practice Address - Country:US
Practice Address - Phone:561-498-3664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4389370001Medicare NSC
FLE85412Medicare UPIN