Provider Demographics
NPI:1801105580
Name:PASCULLO, MEGHAN ROSE (MS OTR/L)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:ROSE
Last Name:PASCULLO
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926-3808
Mailing Address - Country:US
Mailing Address - Phone:845-527-7402
Mailing Address - Fax:
Practice Address - Street 1:16 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:NY
Practice Address - Zip Code:10926-3808
Practice Address - Country:US
Practice Address - Phone:845-527-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015833174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist