Provider Demographics
NPI:1922540459
Name:DUFFY, MEGAN (CRNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:CADEMATORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7056 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1826
Mailing Address - Country:US
Mailing Address - Phone:215-247-2996
Mailing Address - Fax:215-247-7504
Practice Address - Street 1:7056 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1826
Practice Address - Country:US
Practice Address - Phone:215-247-2996
Practice Address - Fax:215-247-7504
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00691100363LP0200X
PASP016718363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics