MEDICARE: MRS. MEGAN BETH SHETH OTR/L

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	225X00000X	Occupational Therapist	008476-1	NY

General Provider Information

NPI Number	:	1265702518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN BETH SHETH OTR/L

Provider Business Mailing Address
First Line	:	735 OLD POST RD
Second Line	:
City	:	NEW PALTZ
State	:	NY
Zip	:	12561-4538
Country	:	US
Telephone Number	:	845-384-6399
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 BROADWAY
Second Line	:
City	:	PORT EWEN
State	:	NY
Zip	:	12466-5501
Country	:	US
Telephone Number	:	845-255-1400
Fax Number	:	845-255-1287

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

Provider Enumeration Date	:	01/04/2012
Last Update Date	:	01/04/2012

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