Provider Demographics
NPI:1619175007
Name:MEGAN, CHRISTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:MEGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1119
Mailing Address - Country:US
Mailing Address - Phone:646-436-4786
Mailing Address - Fax:
Practice Address - Street 1:104 E 40TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1801
Practice Address - Country:US
Practice Address - Phone:212-692-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017153-1103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral