Provider Demographics
NPI:1801965934
Name:MEGLIO, ROBERTA A (PAC)
Entity type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:A
Last Name:MEGLIO
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PUTNAM PIKE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828
Mailing Address - Country:US
Mailing Address - Phone:401-949-5552
Mailing Address - Fax:401-949-5556
Practice Address - Street 1:600 PUTNAM PIKE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828
Practice Address - Country:US
Practice Address - Phone:401-949-5552
Practice Address - Fax:401-949-5556
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA 00177363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant