Healthcare Provider Details

I. General information

NPI: 1629071048
Provider Name (Legal Business Name): MEGAN C KANE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 QUINCY DR
LEVITTOWN PA
19057-1924
US

IV. Provider business mailing address

PO BOX 8500-6335
PHILADELPHIA PA
19178-6335
US

V. Phone/Fax

Practice location:
  • Phone: 215-943-1200
  • Fax: 215-943-6650
Mailing address:
  • Phone: 215-943-1200
  • Fax: 215-943-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS005955L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS005955L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: