Provider Demographics
NPI:1568344265
Name:DIDOMENICO, MEGAN KATHERINE (MSED)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:KATHERINE
Last Name:DIDOMENICO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E 9TH ST APT 203
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-7912
Mailing Address - Country:US
Mailing Address - Phone:703-488-8982
Mailing Address - Fax:
Practice Address - Street 1:50 CENTRAL PARK W APT 1D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6006
Practice Address - Country:US
Practice Address - Phone:646-930-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool