MEDICARE: MEGAN REYNOLDS

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	231H00000X	Audiologist	41YS00809100	NJ

General Provider Information

NPI Number	:	1346634516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN REYNOLDS

Provider Business Mailing Address
First Line	:	156 HEATHER CROFT
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-4621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 HEATHER CROFT
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-4621
Country	:	US
Telephone Number	:	856-381-2682
Fax Number	:

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

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	01/27/2016

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