Healthcare Provider Details
I. General information
NPI: 1831581677
Provider Name (Legal Business Name): MEGAN ANN VULPI P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/03/2015
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27005 76TH AVE
NEW HYDE PARK NY
11040-1402
US
IV. Provider business mailing address
27005 76TH AVE
NEW HYDE PARK NY
11040-1402
US
V. Phone/Fax
- Phone: 718-470-7480
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: