Healthcare Provider Details

I. General information

NPI: 1801750138
Provider Name (Legal Business Name): MEGAN LARINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 ROUTE 112
CORAM NY
11727-4116
US

IV. Provider business mailing address

3600 ROUTE 112
CORAM NY
11727-4116
US

V. Phone/Fax

Practice location:
  • Phone: 631-920-8546
  • Fax: 929-244-4997
Mailing address:
  • Phone: 631-920-8546
  • Fax: 929-244-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: