Provider Demographics
NPI:1396243440
Name:SEGAL, MIRIAM (RN)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 W 95TH ST APT 16H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6764
Mailing Address - Country:US
Mailing Address - Phone:617-947-2177
Mailing Address - Fax:
Practice Address - Street 1:95 W 95TH ST APT 16H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6764
Practice Address - Country:US
Practice Address - Phone:617-947-2177
Practice Address - Fax:617-947-2177
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY738572163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse