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NPI Code Detail

MEDICARE: MRS. MARY L MEEHAN NP

MEDICARE: MRS. MARY L MEEHAN NP
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
1363LF0000XFamily Nurse PractitionerF333826-1NY

General Provider Information

NPI Number : 1992704720
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY L MEEHAN NP
Provider Business Mailing Address
First Line : 1183 MONROE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1662
Country : US
Telephone Number : 585-256-7802
Fax Number : 585-256-7793
Provider Business Practice Location Address
First Line : 1183 MONROE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1662
Country : US
Telephone Number : 585-256-7802
Fax Number : 585-256-7793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 03/28/2017

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