Provider Demographics
NPI:1407399140
Name:DYGON, MEGAN AMY (OTR/L)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:AMY
Last Name:DYGON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 82ND ST
Mailing Address - Street 2:APT 20A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2703
Mailing Address - Country:US
Mailing Address - Phone:732-216-1082
Mailing Address - Fax:
Practice Address - Street 1:525 E 12TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3950
Practice Address - Country:US
Practice Address - Phone:212-982-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021042225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist