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Organization

KIDNEY CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SIMON V SEGUN MD (MD)
(973) 996-2727
Entity
Organization

Contact information

Practice address
2130 MILLBURN AVE, SUITE C3, MAPLEWOOD, NJ 07040-3725
(973) 996-2727
(973) 763-2558
Mailing address
PO BOX 373, SHORT HILLS, NJ 07078-2152
(973) 373-0903
(973) 373-1087

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA08683000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194956490
INDIVIDUAL NPI
NJ
Enumeration date
03/04/2014
Last updated
04/16/2015
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