Basic Information
Provider Information
NPI: 1629334941
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BISHOP
FirstName: MEGHAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 833 CHESTNUT ST STE 520
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191074430
CountryCode: US
TelephoneNumber: 2676064478
FaxNumber: 2673393761
Practice Location
Address1: 450 MAMARONECK AVE
Address2:  
City: HARRISON
State: NY
PostalCode: 105282400
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber: 2674791321
Other Information
ProviderEnumerationDate: 04/11/2012
LastUpdateDate: 11/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X25MA10367200NJN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000XMD464860PAN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207X00000X287195NYY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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