Healthcare Provider Details

I. General information

NPI: 1376122689
Provider Name (Legal Business Name): MEGAN DEYARMOND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14601 45TH AVE
FLUSHING NY
11355-2200
US

IV. Provider business mailing address

311 11TH AVE APT 3520
NEW YORK NY
10001-1752
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-5000
  • Fax:
Mailing address:
  • Phone: 970-355-4962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number336607
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: