Healthcare Provider Details

I. General information

NPI: 1396265344
Provider Name (Legal Business Name): MEGAN TUYEN LE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 BELLEVUE AVE
WEST HAVEN CT
06516-6701
US

IV. Provider business mailing address

66 BELLEVUE AVE
WEST HAVEN CT
06516-6701
US

V. Phone/Fax

Practice location:
  • Phone: 951-427-0936
  • Fax:
Mailing address:
  • Phone: 951-427-0936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberMD19329
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number4301509712
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number036.164621
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036.164621
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number304177
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: