Healthcare Provider Details

I. General information

NPI: 1578077665
Provider Name (Legal Business Name): MEGHAN MCCARTHY RN-IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MAIN ST
BUFFALO NY
14214-2008
US

IV. Provider business mailing address

39 S SHORE DR
ALDEN NY
14004-9206
US

V. Phone/Fax

Practice location:
  • Phone: 716-835-2510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number717335
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: