Healthcare Provider Details
I. General information
NPI: 1134705239
Provider Name (Legal Business Name): MEGAN TAGGART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2021
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 HANDLEY ST STE 2
PERRY NY
14530-1342
US
IV. Provider business mailing address
777 CLINTON AVE S
ROCHESTER NY
14620-1448
US
V. Phone/Fax
- Phone: 585-237-3227
- Fax: 585-237-6075
- Phone: 585-279-4800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 320662 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: