Provider Demographics
NPI:1811238041
Name:FARRELL, MEGHAN JANE (MS ED, TVI)
Entity Type:Individual
Prefix:MISS
First Name:MEGHAN
Middle Name:JANE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MS ED, TVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E 93RD ST
Mailing Address - Street 2:APT. 16 A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3744
Mailing Address - Country:US
Mailing Address - Phone:732-642-1218
Mailing Address - Fax:
Practice Address - Street 1:222 E 93RD ST
Practice Address - Street 2:APT. 16 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3744
Practice Address - Country:US
Practice Address - Phone:732-642-1218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1362882174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist