Provider Demographics
NPI:1467767608
Name:VESELOV, MEGAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:VESELOV
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 DIBELLA DRIVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-1216
Mailing Address - Country:US
Mailing Address - Phone:585-506-8934
Mailing Address - Fax:
Practice Address - Street 1:2061 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-9559
Practice Address - Country:US
Practice Address - Phone:518-869-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist