Basic Information
| Provider Information | |||||||||
| NPI: | 1538107545 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEAGHER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 W MAIN ST STE 267 | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077282537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099219001 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 901 W MAIN ST STE 267 | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077282537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099219001 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 25MA08007100 | NJ | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | MD066999L | PA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | BM6089937 | 01 | PA | DEA | OTHER | 1010812020001 | 05 | PA | MEDICAID |