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General NPI Number Information
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NPI Number | 1508656893
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Entity Type | Individual
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Provider Name | MEGHAN ANDREPONT
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Gender |
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 20 YORK ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3202
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Country | US
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Telephone | 203-688-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 231 GREENE ST APT 2
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City | NEW HAVEN
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State | CT
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Zip | 06511-7412
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 23.007002
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License Number State | CT
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