Provider Demographics
NPI:1588761969
Name:SEGOVIA, EDITH MARGARITA
Entity type:Individual
Prefix:MS
First Name:EDITH
Middle Name:MARGARITA
Last Name:SEGOVIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8631 76TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1007
Mailing Address - Country:US
Mailing Address - Phone:718-413-8160
Mailing Address - Fax:
Practice Address - Street 1:9777 QUEENS BLVD FL 9
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3335
Practice Address - Country:US
Practice Address - Phone:718-267-2420
Practice Address - Fax:718-267-2445
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker