Individual
ITA S SEGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
135 GOLD STAR BLVD, WORCESTER, MA 01606
(508) 853-2716
(508) 856-9025
Mailing address
630 PLANTATION ST, WOT 12TH FLOOR ATTN PHYSICIAN SERVICES, WORCESTER, MA 01605
(508) 368-5529
(508) 368-5530
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
030717
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
ONE HEALTH PLAN
—
01
—
2110458
WELFARE
—
05
—
2110458
—
MA
01
—
347461
TUFTS HEALTH PLAN
—
01
—
77954
FALLON COMMUNITY HEALTH P
—
01
—
786705
MVP HEALTH CARE
—
01
—
AA39601
HARVARD PILGRIM HEALTHCAR
—
01
—
J29502
BLUE CARE ELECT
—
Enumeration date
02/27/2006
Last updated
07/08/2008
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