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General NPI Number Information
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NPI Number | 1205336039
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Entity Type | Individual
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Provider Name | MEGAN CHRISTINE VAUGHN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 159 W 127TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-3723
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Country | US
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Telephone | 212-752-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W 156TH ST APT 1H
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City | NEW YORK
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State | NY
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Zip | 10032-7763
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Country | US
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Telephone | 303-877-6115
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1207067181
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License Number State | NY
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