Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 281009 | NY |
N | 207X00000X | Orthopaedic Surgeon | 62204-20 | WI |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 281009 | NY |
NPI | 1679537476 |
---|---|
Provider Name | Lee S Segal |
First Address | East Syracuse, NY 13057-9791 |
Second Address | East Syracuse, NY 13057-9791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 31/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012168010001 | (05) | PA |
257233 | (05) | AZ |
E55830 | (02) |