Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 55574 | CT |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 55574 | CT |
NPI | 1184948911 |
---|---|
Provider Name | Megan M Gleason |
First Address | Shelton, CT 06484-7622 |
Second Address | Shelton, CT 06484-7622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2010 |
Last Update Date | 16/01/2019 |