Provider Demographics
NPI:1245441773
Name:CARMEL, MEGAN SUZANNE (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:SUZANNE
Last Name:CARMEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-0553
Mailing Address - Fax:
Practice Address - Street 1:995 SENATOR KEATING BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2775
Practice Address - Country:US
Practice Address - Phone:585-368-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260940207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01209341OtherMEDICARE RR
NY03370587Medicaid
NYP01209341OtherMEDICARE RR
NYJ400049734-GRPBA0017Medicare PIN