Provider Demographics
NPI:1275020109
Name:NYIRONGO, MEGAN LEANN (RN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEANN
Last Name:NYIRONGO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2611
Mailing Address - Country:US
Mailing Address - Phone:855-980-7566
Mailing Address - Fax:
Practice Address - Street 1:625 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2611
Practice Address - Country:US
Practice Address - Phone:855-980-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19893700163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse