Provider Demographics
NPI:1700482098
Name:SEGAL, LEE JAY (RPH)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:JAY
Last Name:SEGAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HILLCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2322
Mailing Address - Country:US
Mailing Address - Phone:267-968-0446
Mailing Address - Fax:
Practice Address - Street 1:1700 HORIZON DR STE 105
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3950
Practice Address - Country:US
Practice Address - Phone:267-956-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036874L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist