Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X002983-1 | NY |
NPI | 1104988567 |
---|---|
Provider Name | Dr. James Alexander Meglino |
First Address | Glens Falls, NY 12801-2906 |
Second Address | Glens Falls, NY 12801-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CO29837 | WORKERS' COMP (01) | NY |
X32031 | EMPIRE BLUE CROSS (01) | NM |