Provider Demographics
NPI:1639915531
Name:RIDOLFO, MEGHAN C
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:C
Last Name:RIDOLFO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAGGI
Other - Middle Name:
Other - Last Name:RIDOLFO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:46 SOUTHERN LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1908
Mailing Address - Country:US
Mailing Address - Phone:718-536-6867
Mailing Address - Fax:
Practice Address - Street 1:46 SOUTHERN LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1908
Practice Address - Country:US
Practice Address - Phone:718-536-6867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist