Provider Demographics
NPI:1447615398
Name:NEGA, MERON
Entity Type:Individual
Prefix:
First Name:MERON
Middle Name:
Last Name:NEGA
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 1:7032 HANOVER PKWY
Mailing Address - Street 2:APT # B1
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2054
Mailing Address - Country:US
Mailing Address - Phone:240-432-1849
Mailing Address - Fax:
Practice Address - Street 1:7032 HANOVER PKWY
Practice Address - Street 2:APT # B1
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2054
Practice Address - Country:US
Practice Address - Phone:240-432-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-19
Last Update Date:2015-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02288224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant