Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 282261 | NY |
NPI | 1205151768 |
---|---|
Provider Name | Megan Carroll Paulus |
First Address | East Setauket, NY 11733-3472 |
Second Address | East Setauket, NY 11733-3472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2010 |
Last Update Date | 29/08/2016 |