Provider Demographics
NPI:1427353994
Name:SEGALL, ALISON BRETT (PA)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:BRETT
Last Name:SEGALL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 E 7TH ST
Mailing Address - Street 2:APT D6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-6242
Mailing Address - Country:US
Mailing Address - Phone:914-450-4701
Mailing Address - Fax:
Practice Address - Street 1:158 E 7TH ST
Practice Address - Street 2:APT D6
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-6282
Practice Address - Country:US
Practice Address - Phone:914-450-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013772363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant