Provider Demographics
NPI:1043885213
Name:SEGALL PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:SEGALL PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:847-217-9371
Mailing Address - Street 1:3 JOHNSON PL
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1140
Mailing Address - Country:US
Mailing Address - Phone:847-217-9371
Mailing Address - Fax:
Practice Address - Street 1:125 W 72ND ST RM 5F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3278
Practice Address - Country:US
Practice Address - Phone:847-217-9371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty