Provider Demographics
NPI:1023373743
Name:FILADELFO, MEGAN (OD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:FILADELFO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MCPHAIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:230 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040
Mailing Address - Country:US
Mailing Address - Phone:413-420-2108
Mailing Address - Fax:413-533-0472
Practice Address - Street 1:230 MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-420-2108
Practice Address - Fax:413-533-0472
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003752A152W00000X
RIODTG00580152W00000X
MA5069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist