Provider Demographics
NPI:1821433012
Name:SEGAL, NOAH MAXWELL (DC)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:MAXWELL
Last Name:SEGAL
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 1:950 PENINSULA CORPORATE CIR STE 1003
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1384
Mailing Address - Country:US
Mailing Address - Phone:561-220-1989
Mailing Address - Fax:
Practice Address - Street 1:950 PENINSULA CORPORATE CIR STE 1003
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1384
Practice Address - Country:US
Practice Address - Phone:561-220-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11924111N00000X
NJ38MC00709000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty