Provider Demographics
NPI:1477514842
Name:SEGEE, ALAN (MED, ATC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:SEGEE
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FERA ST
Mailing Address - Street 2:#102
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4100
Mailing Address - Country:US
Mailing Address - Phone:401-335-3931
Mailing Address - Fax:
Practice Address - Street 1:8 ABBOTT PARK PL
Practice Address - Street 2:ATHLETIC DEPARTMENT
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-3703
Practice Address - Country:US
Practice Address - Phone:401-598-1626
Practice Address - Fax:401-598-1601
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAT000852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer