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NPI Code Detail

MEDICARE: MEGHAN ROESCH

MEDICARE: MEGHAN ROESCH
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
1208100000XPhysical Medicine & Rehabilitation Physician2015017197MO

General Provider Information

NPI Number : 1700266590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN ROESCH
Provider Business Mailing Address
First Line : PO BOX 22239
Second Line :
City : NEW YORK
State : NY
Zip : 10087-0001
Country : US
Telephone Number : 702-899-0595
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 600 BREEZE PARK DR
Second Line :
City : WELDON SPRING
State : MO
Zip : 63304-9139
Country : US
Telephone Number : 872-231-3162
Fax Number : 702-977-1496
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2015
Last Update Date : 01/26/2026

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