Provider Demographics
NPI:1730608134
Name:BUCKINGHAM, MEGAN ELLEN (MSED SLP-CFY)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELLEN
Last Name:BUCKINGHAM
Suffix:
Gender:F
Credentials:MSED SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3121
Mailing Address - Country:US
Mailing Address - Phone:315-777-3409
Mailing Address - Fax:
Practice Address - Street 1:1477 S SCHODACK RD
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-9644
Practice Address - Country:US
Practice Address - Phone:315-777-3409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist