Provider Demographics
NPI:1104229244
Name:DANAHER, MEGAN (PT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DANAHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 W BRIGANTINE AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1655
Mailing Address - Country:US
Mailing Address - Phone:609-264-5403
Mailing Address - Fax:609-800-5486
Practice Address - Street 1:3103 W BRIGANTINE AVE
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-1655
Practice Address - Country:US
Practice Address - Phone:609-264-5403
Practice Address - Fax:609-800-5486
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE388805Y0XMedicare PIN