Provider Demographics
NPI:1548344716
Name:MEEHAN, JAMES R
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MEEHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1018
Mailing Address - Country:US
Mailing Address - Phone:518-842-9737
Mailing Address - Fax:
Practice Address - Street 1:365 DIVISION ST
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1018
Practice Address - Country:US
Practice Address - Phone:518-842-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004374-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor