Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 38382374 | NY |
NPI | 1013258789 |
---|---|
Provider Name | Meghan R Mcshea |
First Address | Bronx, NY 10457-7606 |
Second Address | Bronx, NY 10457-7606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2013 |
Last Update Date | 28/10/2013 |