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General NPI Number Information
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NPI Number | 1245625169
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Entity Type | Individual
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Provider Name | MEGHAN KILEY METCALF M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC CARDIOLOGY
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-590-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 311 HOUSTON AVE
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City | MINEOLA
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State | NY
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Zip | 11501-1322
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Country | US
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Telephone | 516-633-7957
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 25MA11573900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | MT216095
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License Number State | PA
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