Provider Demographics
NPI:1699042804
Name:SEGARRA, BETTY (RN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:SEGARRA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HIGHVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-7209
Mailing Address - Country:US
Mailing Address - Phone:845-227-6817
Mailing Address - Fax:
Practice Address - Street 1:15 ENTRY RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6046
Practice Address - Country:US
Practice Address - Phone:845-227-1756
Practice Address - Fax:845-227-1751
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297106-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool