Provider Demographics
NPI:1205170123
Name:FRANK S SEGRETO MD PC
Entity type:Organization
Organization Name:FRANK S SEGRETO MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-737-6767
Mailing Address - Street 1:3385 VETERANS MEMORIAL HWY
Mailing Address - Street 2:SUITE I
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-7660
Mailing Address - Country:US
Mailing Address - Phone:631-737-6767
Mailing Address - Fax:631-737-5068
Practice Address - Street 1:3385 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE I
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-7660
Practice Address - Country:US
Practice Address - Phone:631-737-6767
Practice Address - Fax:631-737-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty