Bryan Whitman Segall, SCLA, CSAA

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

4902 Queens Blvd
Woodside, NY 11377-4444

Phone

(718) 458-5333

Fax

(718) 458-5335

NPI assigned

Oct 6, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1669707881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 UTOPIA PKWY",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582735",
            "telephone_number": "646-322-2970",
            "fax_number": "718-458-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 QUEENS BLVD",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774444",
            "telephone_number": "718-458-5333",
            "fax_number": "718-458-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGALL",
        "first_name": "BRYAN",
        "middle_name": "WHITMAN",
        "name_prefix": "Mr.",
        "credential": "SCLA, CSAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Woodside, NY
• Providers in Woodside, NY by specialty
• Contractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.