Basic Information
Provider Information
NPI: 1588778955
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HYLAND
FirstName: MEGAN
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 ELMWOOD AVE
Address2: BOX 278984
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: 5852751200
FaxNumber: 5857565189
Practice Location
Address1: 919 WESTFALL RD
Address2: BLDG C, STE 220
City: ROCHESTER
State: NY
PostalCode: 146182628
CountryCode: US
TelephoneNumber: 5853417500
FaxNumber: 5853417510
Other Information
ProviderEnumerationDate: 08/19/2006
LastUpdateDate: 03/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084N0400X266506NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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