Provider Demographics
NPI:1336349620
Name:SEGAL, LEOPOLDO NICOLAS (MD)
Entity Type:Individual
Prefix:
First Name:LEOPOLDO
Middle Name:NICOLAS
Last Name:SEGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WRIGHT PL
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5309
Mailing Address - Country:US
Mailing Address - Phone:347-306-6208
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:ROOM 7N24
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-263-6479
Practice Address - Fax:212-263-8442
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60 244941207RP1001X
NY244941207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease