Provider Demographics
NPI:1821767872
Name:MALONEY, MEGHAN (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:MALONEY
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 OLD KINGS HWY S STE 200
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 OLD KINGS HWY S STE 200
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4523
Practice Address - Country:US
Practice Address - Phone:203-899-5027
Practice Address - Fax:203-899-5027
Is Sole Proprietor?:No
Enumeration Date:2021-09-12
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310089363LA2200X
CT10083363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health