Provider Demographics
NPI:1013297076
Name:IHM, MEIRA B (MSSPED)
Entity Type:Individual
Prefix:
First Name:MEIRA
Middle Name:B
Last Name:IHM
Suffix:
Gender:F
Credentials:MSSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14709 76TH AVE
Mailing Address - Street 2:APT 1D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3150
Mailing Address - Country:US
Mailing Address - Phone:412-848-8406
Mailing Address - Fax:
Practice Address - Street 1:14709 76TH AVE
Practice Address - Street 2:APT 1D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3150
Practice Address - Country:US
Practice Address - Phone:412-848-8406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11183555222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist