MEDICARE: DANIEL MEGNA MD

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	207RG0100X	Gastroenterology Physician	109421	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	100002427	OTHER	NY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235119660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL MEGNA MD

Provider Business Mailing Address
First Line	:	360 EDISON ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306
Country	:	US
Telephone Number	:	718-351-6277
Fax Number	:	718-980-7341

Provider Business Practice Location Address
First Line	:	360 EDISON ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3041
Country	:	US
Telephone Number	:	718-351-6277
Fax Number	:	718-980-7341

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	05/16/2008

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