Provider Demographics
NPI:1760747356
Name:RIVERA-SEGARRA, STEPHANIE DENISE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DENISE
Last Name:RIVERA-SEGARRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DEAN DR
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2765
Mailing Address - Country:US
Mailing Address - Phone:201-569-3300
Mailing Address - Fax:201-569-7649
Practice Address - Street 1:2 DEAN DR
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2765
Practice Address - Country:US
Practice Address - Phone:201-569-3300
Practice Address - Fax:201-569-7649
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09942700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology