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General NPI Number Information
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NPI Number | 1023486610
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Entity Type | Individual
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Provider Name | KIMBERLY MEEHAN
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Gender | Female
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Dates
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Enumeration Date | 09/13/2015
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 18 E 41ST ST FL 14 C/O LINA
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City | NEW YORK
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State | NY
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Zip | 10017-6244
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Country | US
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Telephone | 646-434-8958
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Fax | 979-987-3062
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Provider Business Mailing Address
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Address Line | 18 E 41ST ST FL 14 C/O LINA
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City | NEW YORK
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State | NY
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Zip | 10017-6244
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Country | US
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Telephone | 401-864-7253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 402330
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License Number State | NY
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