1770955445 NPI number — MEGHAN CHASE PNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770955445 NPI number — MEGHAN CHASE PNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHASE
Provider First Name:
MEGHAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARRIS
Provider Other First Name:
MEGHAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1770955445
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ANDOVER PEDIATRICS
Provider Second Line Business Mailing Address:
203 TURNPIKE ST, SUITE 200
Provider Business Mailing Address City Name:
NORTH ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-475-4522
Provider Business Mailing Address Fax Number:
978-688-6047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ANDOVER PEDIATRICS
Provider Second Line Business Practice Location Address:
203 TURNPIKE ST, SUITE 200
Provider Business Practice Location Address City Name:
NORTH ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-475-4522
Provider Business Practice Location Address Fax Number:
978-688-6047
Provider Enumeration Date:
10/21/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  RN2278815 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110108377A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com