Provider Demographics
NPI:1386980316
Name:EMERY, MEGAN C (RD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:EMERY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 93RD ST APT 17G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5521
Mailing Address - Country:US
Mailing Address - Phone:484-437-9298
Mailing Address - Fax:
Practice Address - Street 1:350 CENTRAL PARK W APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8842
Practice Address - Country:US
Practice Address - Phone:484-437-9298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0000488133V00000X
DEDN0000488133V00000X
PA1080646133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered