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General NPI Number Information
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NPI Number | 1598894404
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Entity Type | Individual
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Provider Name | MEGAN F WATSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 2660 MAIN ST SUITE 216
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City | BRIDGEPORT
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State | CT
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Zip | 06606-5369
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Country | US
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Telephone | 203-576-6249
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Fax | 203-581-6509
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Provider Business Mailing Address
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Address Line | 2800 MAIN ST
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4201
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Country | US
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Telephone | 203-576-5436
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Fax | 203-581-6512
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001616
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License Number State | CT
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