Individual
BENJAMIN SEGALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 W PROSPECT ST, EAST BRUNSWICK, NJ 08816-2161
(732) 254-0600
Mailing address
16 KLETSK HILL RD, LAKEWOOD, NJ 08701-2971
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05788500
NJ
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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