Provider Demographics
NPI:1285059881
Name:HATTERSLEY, MEGHAN MICHELLE
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MICHELLE
Last Name:HATTERSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:MICHELLE
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1806 SWAMP PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9307
Mailing Address - Country:US
Mailing Address - Phone:484-948-2800
Mailing Address - Fax:610-792-3044
Practice Address - Street 1:19 W LINFIELD TRAPPE RD
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1807
Practice Address - Country:US
Practice Address - Phone:484-948-2800
Practice Address - Fax:610-792-3044
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA80393382Medicare PIN