Provider Demographics
NPI:1033992656
Name:YOST, MEAGHAN GAVEY (PA)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:GAVEY
Last Name:YOST
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:PETERSEN
Other - Last Name:GAVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:168 ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 JOYCE KILMER AVE UNIT 210
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3363
Practice Address - Country:US
Practice Address - Phone:732-418-0709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00795700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant