Provider Demographics
NPI:1295115806
Name:MOLLARD, MEAGHAN (FHNP)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:MOLLARD
Suffix:
Gender:F
Credentials:FHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:391 MYRTLE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3797
Mailing Address - Country:US
Mailing Address - Phone:518-262-5640
Mailing Address - Fax:518-262-9413
Practice Address - Street 1:391 MYRTLE AVE., SUITE 5
Practice Address - Street 2:THE VASCULAR GROUP, PLLC
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5640
Practice Address - Fax:518-262-9413
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF339641363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04175339Medicaid
NYJ400232509Medicare PIN