1881694974 NPI number — WILLIAM N SEGAL MD

Table of content: WILLIAM N SEGAL MD (NPI 1881694974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881694974 NPI number — WILLIAM N SEGAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEGAL
Provider First Name:
WILLIAM
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881694974
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
731 ALEXANDER RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08540-6345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-924-1422
Provider Business Mailing Address Fax Number:
609-924-7473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
731 ALEXANDER RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-6345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-924-1422
Provider Business Practice Location Address Fax Number:
609-924-7473
Provider Enumeration Date:
07/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  25MA06364000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0821011000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P399224 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000795866 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100010067 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1492643004 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00795866 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000865670 . This is a "AMERIHEALTH PERS. CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7517106 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0981974000 . This is a "AMERIHEALTH HMO" identifier . This identifiers is of the category "OTHER".




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