Healthcare Provider Details

I. General information

NPI: 1922857077
Provider Name (Legal Business Name): MEREDITH ELISE MEAGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10B MADISON AVENUE EXT
ALBANY NY
12203-7314
US

IV. Provider business mailing address

348 MILTON AVE
BALLSTON SPA NY
12020-1415
US

V. Phone/Fax

Practice location:
  • Phone: 518-867-3061
  • Fax:
Mailing address:
  • Phone: 607-296-8384
  • 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 State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: