Basic Information
| Provider Information | |||||||||
| NPI: | 1750404398 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGUIRE | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | BETH | ||||||||
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| OtherLastName: | MCGUIRE | ||||||||
| OtherFirstName: | MEGAN | ||||||||
| OtherMiddleName: | B ETH | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | AUD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 32 LINDA CT | ||||||||
| Address2: | |||||||||
| City: | DELMAR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120543514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184759359 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 EXECUTIVE CENTRE DR | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122036344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186902060 | ||||||||
| FaxNumber: | 5186907111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 001651-1 | NY | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.