Basic Information
| Provider Information | |||||||||
| NPI: | 1639362940 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MEGHAN MCNALLY | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHILD'S PLAY OCCUPATIONAL THERAPY, PLLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1695 ALLEN GLEN RD | ||||||||
| Address2: | |||||||||
| City: | OWEGO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138273433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077257420 | ||||||||
| FaxNumber: | 6076874249 | ||||||||
| Practice Location | |||||||||
| Address1: | 1695 ALLEN GLEN RD | ||||||||
| Address2: | |||||||||
| City: | OWEGO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138273433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077257420 | ||||||||
| FaxNumber: | 6076874249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2007 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | MCNALLY | ||||||||
| AuthorizedOfficialFirstName: | MEGHAN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6077257420 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MASS, OTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 008575-1 | NY | Y | Agencies | Home Health |
No ID Information.