Provider Demographics
NPI:1235258856
Name:MEEHAN, MAUREEN (FNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HARMON PL
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2804
Mailing Address - Country:US
Mailing Address - Phone:845-638-4141
Mailing Address - Fax:845-638-4360
Practice Address - Street 1:6 HARMON PL
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2804
Practice Address - Country:US
Practice Address - Phone:845-638-4141
Practice Address - Fax:845-638-4360
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily