Provider Demographics
NPI:1124174164
Name:MILLER, MEGHAN H (PT)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:H
Last Name:MILLER
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 1:110 STATESVILLE QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-3129
Mailing Address - Country:US
Mailing Address - Phone:973-702-3185
Mailing Address - Fax:
Practice Address - Street 1:101 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1930
Practice Address - Country:US
Practice Address - Phone:973-729-1222
Practice Address - Fax:973-729-1220
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00853100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ069636Medicare PIN