Provider Demographics
NPI:1306411400
Name:ULREY, MEGAN MARIE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:ULREY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 S 3RD ST APT 3106
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2177
Mailing Address - Country:US
Mailing Address - Phone:620-803-2399
Mailing Address - Fax:
Practice Address - Street 1:777 S 3RD ST APT 3106
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-2177
Practice Address - Country:US
Practice Address - Phone:620-803-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY649852163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant