Provider Demographics
NPI:1487251906
Name:ALCALA, MEGHANN (DNP)
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:
Last Name:ALCALA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 STEGMAN PKWY
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1408
Mailing Address - Country:US
Mailing Address - Phone:917-698-5860
Mailing Address - Fax:
Practice Address - Street 1:188 W 230TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5215
Practice Address - Country:US
Practice Address - Phone:845-279-5908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF403244363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health