Basic Information
Provider Information
NPI: 1982377131
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAY
FirstName: MEGAN
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CRAWFORD
OtherFirstName: MEGAN
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 900 CHISWELL DR
Address2:  
City: DOWNINGTOWN
State: PA
PostalCode: 193354151
CountryCode: US
TelephoneNumber: 4843370000
FaxNumber:  
Practice Location
Address1: 130 S BRYN MAWR AVE
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103121
CountryCode: US
TelephoneNumber: 4843373000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2021
LastUpdateDate: 10/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/28/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XSP024148PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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