Provider Demographics
NPI:1902142185
Name:SEGAL, SUSAN (APRN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 LITTLETON RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3191
Mailing Address - Country:US
Mailing Address - Phone:978-302-6901
Mailing Address - Fax:
Practice Address - Street 1:174 LITTLETON RD
Practice Address - Street 2:CVS MINUTECLINIC
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3191
Practice Address - Country:US
Practice Address - Phone:978-692-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN236188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily