Provider Demographics
NPI:1487200929
Name:CAHILL, MEAGHAN ELISABETH
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ELISABETH
Last Name:CAHILL
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 1:1055 CHARLOTTE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NY
Mailing Address - Zip Code:12175-2602
Mailing Address - Country:US
Mailing Address - Phone:518-287-1835
Mailing Address - Fax:
Practice Address - Street 1:112 OLD JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:FONDA
Practice Address - State:NY
Practice Address - Zip Code:12068-5410
Practice Address - Country:US
Practice Address - Phone:518-853-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY427480224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant