Provider Demographics
NPI:1477011773
Name:AUSTIN-APPLETON, MEREDITH NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:NOEL
Last Name:AUSTIN-APPLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:516-614-7251
Mailing Address - Fax:
Practice Address - Street 1:PEDIATRIC URGENT CARE OF ROCHESTER
Practice Address - Street 2:6687 PITTSFORD PALMYRA RD
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450
Practice Address - Country:US
Practice Address - Phone:585-678-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2020-08-25
Deactivation Date:2019-10-16
Deactivation Code:
Reactivation Date:2020-08-25
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY306308208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
106759OtherCPSO (ONTARIO)