Individual
MEGAN L GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6930
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307281
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720466469
—
NY
Enumeration date
06/29/2015
Last updated
11/21/2019
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