Individual
MEGHAN KATHLEEN LIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(917) 749-9440
Mailing address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(917) 749-9440
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
407512
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008151
—
NY
Enumeration date
12/06/2011
Last updated
09/05/2025
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