Provider Demographics
NPI:1174867097
Name:CAFFREY, MEGHAN P (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:P
Last Name:CAFFREY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HEWITT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4614
Mailing Address - Country:US
Mailing Address - Phone:718-873-5733
Mailing Address - Fax:
Practice Address - Street 1:56 HEWITT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4614
Practice Address - Country:US
Practice Address - Phone:718-873-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58022452235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist