MEDICARE: DR. ELIZABETH MEEKER PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	014082-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160846FC	OTHER	NY	PROVIDER ID

General Provider Information

NPI Number	:	1225094311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH MEEKER PSY.D.

Provider Business Mailing Address
First Line	:	3700 EAST AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3527
Country	:	US
Telephone Number	:	585-248-8740
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 EAST AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3527
Country	:	US
Telephone Number	:	585-248-8740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

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