Provider Demographics
NPI:1184032948
Name:KOVAC, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KOVAC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 N CENTRAL AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1839
Mailing Address - Country:US
Mailing Address - Phone:203-273-3637
Mailing Address - Fax:914-949-3224
Practice Address - Street 1:280 N CENTRAL AVE STE 305
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1839
Practice Address - Country:US
Practice Address - Phone:203-273-3637
Practice Address - Fax:914-949-3224
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021829103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist