Basic Information
Provider Information | |||||||||
NPI: | 1972709525 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GONZALEZ-SEGARRA | ||||||||
FirstName: | NAGGAI | ||||||||
MiddleName: | YAMIR | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | GONZALEZ-SEGARRA | ||||||||
OtherFirstName: | NAGGAI | ||||||||
OtherMiddleName: | YAMIR | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 2 | ||||||||
Mailing Information | |||||||||
Address1: | A3 PLAZA 6 | ||||||||
Address2: | URB. QUINTA DEL RIO | ||||||||
City: | BAYAMON | ||||||||
State: | PR | ||||||||
PostalCode: | 009613001 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7875981486 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | UNIVERSITY DISTRICT HOSPITAL | ||||||||
Address2: | MEDICAL CENTER UDH ADULT 2 | ||||||||
City: | SAN JUAN | ||||||||
State: | PR | ||||||||
PostalCode: | 009222116 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7877540101 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/21/2007 | ||||||||
LastUpdateDate: | 01/23/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 18205 | PR | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.