Provider Demographics
NPI:1932472727
Name:SEGAL, DEVORAH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DEVORAH
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:DEVORAH
Other - Middle Name:
Other - Last Name:STEINMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST # 91
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-3278
Mailing Address - Fax:212-746-8137
Practice Address - Street 1:505 E 70TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-3278
Practice Address - Fax:212-746-8137
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2783592084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY131623978Medicaid