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General NPI Number Information
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NPI Number | 1205151768
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Entity Type | Individual
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Provider Name | MEGAN CARROLL PAULUS M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2010
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 14 TECHNOLOGY DR SUITE 11
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3472
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Country | US
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Telephone | 631-444-4233
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Fax | 631-444-4217
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Provider Business Mailing Address
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Address Line | 14 TECHNOLOGY DR SUITE 11
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3472
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Country | US
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Telephone | 631-444-4233
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Fax | 631-444-4217
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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 | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 282261
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License Number State | NY
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