Provider Demographics
NPI:1750417713
Name:SEGAL-MAURER, SORANA (MD)
Entity type:Individual
Prefix:
First Name:SORANA
Middle Name:
Last Name:SEGAL-MAURER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:DIVISION OF INFECTIOUS DISEASES
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-670-1525
Mailing Address - Fax:718-321-8857
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:DIVISION OF INFECTIOUS DISEASES
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1525
Practice Address - Fax:718-321-8857
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179003207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0580881OtherAETNA
NYH290013OtherELDERPLAN
NY30174POtherHIP NY
NY01553240Medicaid
NYDS540OtherOXFORD
NY0342034OtherCIGNA
NY4C4809OtherHEALTHNET
NY66H951OtherBLUE CROSS
NY5600028OtherGHI
NY5600028OtherGHI
NY01035Medicare PIN