Basic Information
| Provider Information | |||||||||
| NPI: | 1235796756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POIRIER | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 52 SARAH CIR | ||||||||
| Address2: | |||||||||
| City: | SPENCERPORT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145599591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855455156 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146429591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852751509 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2019 | ||||||||
| LastUpdateDate: | 10/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208G00000X | 024285 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.