Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 052151 | NY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 260072 | NY |
NPI | 1154595734 |
---|---|
Provider Name | Dr. Joshua David Segal |
First Address | Brooklyn, NY 11212-3139 |
Second Address | Brooklyn, NY 11212-3139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 15/07/2013 |