Provider Demographics
NPI:1508307729
Name:DAVIS, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DAVIS
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 1:716 EDIE RD
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:NY
Mailing Address - Zip Code:12809-1623
Mailing Address - Country:US
Mailing Address - Phone:518-727-3595
Mailing Address - Fax:518-531-4025
Practice Address - Street 1:716 EDIE RD
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:NY
Practice Address - Zip Code:12809-1623
Practice Address - Country:US
Practice Address - Phone:518-727-3595
Practice Address - Fax:518-531-4025
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind