Provider Demographics
NPI:1154684546
Name:MEREGILDO, ROSA (SPECIAL EDUCATOR)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:MEREGILDO
Suffix:
Gender:F
Credentials:SPECIAL EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 BAILEY AVE APT DE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2772
Mailing Address - Country:US
Mailing Address - Phone:646-765-3398
Mailing Address - Fax:
Practice Address - Street 1:3900 BAILEY AVE APT DE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2772
Practice Address - Country:US
Practice Address - Phone:646-765-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor