Healthcare Provider Details

I. General information

NPI: 1508582495
Provider Name (Legal Business Name): MEGHAN MCGUIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 MANHATTAN AVE
BROOKLYN NY
11222-1625
US

IV. Provider business mailing address

60 W 57TH ST APT 4E
NEW YORK NY
10019-3953
US

V. Phone/Fax

Practice location:
  • Phone: 718-383-7200
  • Fax:
Mailing address:
  • Phone: 732-796-4374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number857720-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: