Provider Demographics
NPI:1366913147
Name:MADDEN, MEGAN (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 ADAIR PL
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2512
Mailing Address - Country:US
Mailing Address - Phone:516-376-9277
Mailing Address - Fax:
Practice Address - Street 1:801 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-4748
Practice Address - Country:US
Practice Address - Phone:516-393-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist