Healthcare Provider Details

I. General information

NPI: 1689973190
Provider Name (Legal Business Name): MEGAN CALLANAN LASAPONARA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. MEGAN CALLANAN LASAPONARA

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ENGLISH RD SUITE 10
ROCHESTER NY
14616-1691
US

IV. Provider business mailing address

1800 ENGLISH RD SUITE 10
ROCHESTER NY
14616-1691
US

V. Phone/Fax

Practice location:
  • Phone: 585-225-2525
  • Fax: 585-225-2626
Mailing address:
  • Phone: 585-225-2525
  • Fax: 585-225-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number276133
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: