Provider Demographics
NPI:1093071599
Name:CREEGAN, MAUREEN W (MSED)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:W
Last Name:CREEGAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ROCHELLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5853
Mailing Address - Country:US
Mailing Address - Phone:845-300-9939
Mailing Address - Fax:
Practice Address - Street 1:333 WESTCHESTER AVE.
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-5853
Practice Address - Country:US
Practice Address - Phone:845-300-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY851481390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program