Provider Demographics
NPI:1275390155
Name:MUNOZ, MEGHAN KILEY
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:KILEY
Last Name:MUNOZ
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 1:460 N FRANKLIN ST APT 115
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1407
Mailing Address - Country:US
Mailing Address - Phone:602-575-0662
Mailing Address - Fax:
Practice Address - Street 1:460 N FRANKLIN ST APT 115
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1407
Practice Address - Country:US
Practice Address - Phone:602-575-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program