Active NPI
Meghan Dambach
- Pediatrics Physician
- Liverpool, NY
National Provider Identifier
1003428418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- F345952-01
- Practice address
- 4811 Buckley Rd
Liverpool, NY 13088-3629 - Phone
- (315) 457-9966
- NPI assigned
- Aug 18, 2020
- Last updated
- Aug 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | F345952-01 | NY | Primary |
Addresses
Primary practice location
4811 Buckley Rd
Liverpool, NY 13088-3629
Mailing address
4811 Buckley Rd
Liverpool, NY 13088-3676
Phone (315) 457-9966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F345952-01 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1003428418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4811 BUCKLEY RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130883676",
"telephone_number": "315-457-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4811 BUCKLEY RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130883629",
"telephone_number": "315-457-9966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMBACH",
"first_name": "MEGHAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-18",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "F345952-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.