Provider Demographics
NPI:1235461187
Name:LAFAVE, MEGAN LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:LEIGH
Last Name:LAFAVE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2283 GRAND ISLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1819
Mailing Address - Country:US
Mailing Address - Phone:716-688-8815
Mailing Address - Fax:
Practice Address - Street 1:550 HARRISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3188
Practice Address - Country:US
Practice Address - Phone:315-464-8186
Practice Address - Fax:315-464-6482
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor