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NPI Code Detail

MEDICARE: MEGAN MARUMOTO M.D.

MEDICARE: MEGAN MARUMOTO M.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
12084P0800XPsychiatry PhysicianDR.0069278CO
22084P0804XChild & Adolescent Psychiatry PhysicianMD-9818HI
32084P0804XChild & Adolescent Psychiatry Physician0101257141VA
42084P0800XPsychiatry Physician2067682UPDNY

General Provider Information

NPI Number : 1760472765
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN MARUMOTO M.D.
Provider Business Mailing Address
First Line : 109 W 27TH ST STE 5S
Second Line :
City : NEW YORK
State : NY
Zip : 10001-6208
Country : US
Telephone Number : 833-351-8255
Fax Number : 888-815-3583
Provider Business Practice Location Address
First Line : 109 W 27TH ST RM 5S
Second Line :
City : NEW YORK
State : NY
Zip : 10001-6208
Country : US
Telephone Number : 833-351-8255
Fax Number : 888-815-3583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 04/21/2025

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