Healthcare Provider Details

I. General information

NPI: 1205621398
Provider Name (Legal Business Name): MEGAN WELLS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 BROADWAY
NEW YORK NY
10034-1159
US

IV. Provider business mailing address

350 W 85TH ST APT 61
NEW YORK NY
10024-3851
US

V. Phone/Fax

Practice location:
  • Phone: 212-932-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number028663
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: