Healthcare Provider Details

I. General information

NPI: 1750208385
Provider Name (Legal Business Name): MEGAN CARREJO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 W 25TH ST FL 10
NEW YORK NY
10001-7265
US

IV. Provider business mailing address

118 E 4TH ST APT 2
NEW YORK NY
10003-0726
US

V. Phone/Fax

Practice location:
  • Phone: 575-430-0319
  • Fax:
Mailing address:
  • Phone: 575-430-0319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408860
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: