Provider Demographics
NPI:1194496158
Name:HESLOP, MEAGAN LORRAINE (PHARMD)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LORRAINE
Last Name:HESLOP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 RENFREW AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2821
Mailing Address - Country:US
Mailing Address - Phone:516-325-6407
Mailing Address - Fax:
Practice Address - Street 1:1730 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1856
Practice Address - Country:US
Practice Address - Phone:516-326-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist