Provider Demographics
NPI:1629390141
Name:GRUPPE, MEGAN LEIGH (RPH)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LEIGH
Last Name:GRUPPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 W TAFT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-2703
Mailing Address - Country:US
Mailing Address - Phone:315-883-3333
Mailing Address - Fax:315-452-0040
Practice Address - Street 1:5221 W TAFT RD
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-2703
Practice Address - Country:US
Practice Address - Phone:315-883-3333
Practice Address - Fax:315-452-0040
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046850-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist