Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | F380513 | NY |
NPI | 1225136070 |
---|---|
Provider Name | Meggan Butler-O'hara |
First Address | Rochester, NY 14617-5504 |
Second Address | Newark, NY 14513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 06/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02058639 | (05) | NY |