MEDICARE: MS. MEGAN B CUNNINGHAM MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	018016-1	NY

General Provider Information

NPI Number	:	1235376211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MEGAN B CUNNINGHAM MS, CCC-SLP

Provider Business Mailing Address
First Line	:	108 SUNSET BEACH RD
Second Line	:
City	:	NORTH EAST
State	:	PA
Zip	:	16428-3056
Country	:	US
Telephone Number	:	814-215-7619
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 SUNSET BEACH RD
Second Line	:
City	:	NORTH EAST
State	:	PA
Zip	:	16428-3056
Country	:	US
Telephone Number	:	814-215-7619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	01/14/2009

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