Provider Demographics
NPI:1295283695
Name:MEZA, NANCY LYNN (SPECIAL ED TE)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:MEZA
Suffix:
Gender:F
Credentials:SPECIAL ED TE
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LYNN
Other - Last Name:MCCRUDDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPECIAL ED TEACHER
Mailing Address - Street 1:22 DAISY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-5526
Mailing Address - Country:US
Mailing Address - Phone:914-806-2755
Mailing Address - Fax:
Practice Address - Street 1:22 DAISY DRIVE
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-5526
Practice Address - Country:US
Practice Address - Phone:914-556-6044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist