Provider Demographics
NPI:1225271794
Name:MEGLIO, AMANDA (PT, LAC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:MEGLIO
Suffix:
Gender:F
Credentials:PT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 SPRINGBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572
Mailing Address - Country:US
Mailing Address - Phone:845-871-3427
Mailing Address - Fax:845-871-4307
Practice Address - Street 1:6511 SPRINGBROOK AVE.
Practice Address - Street 2:6
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572
Practice Address - Country:US
Practice Address - Phone:845-871-3427
Practice Address - Fax:845-871-4307
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3936.1171100000X
NY016957.1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00268300Medicaid
NY00268300Medicaid