Provider Demographics
NPI:1114294550
Name:DEBENEDICTIS, MEGHAN JO (MS, LGC, MED)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:JO
Last Name:DEBENEDICTIS
Suffix:
Gender:F
Credentials:MS, LGC, MED
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:JO
Other - Last Name:MARINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # I-31
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-7671
Mailing Address - Fax:216-445-2226
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:OPHTHALMIC RESEARCH/I3-117
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-7671
Practice Address - Fax:216-445-3670
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS