Provider Demographics
NPI:1326474883
Name:EGAY, MELANIE (PT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:EGAY
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 1:455 COLONIAL TER
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1403
Mailing Address - Country:US
Mailing Address - Phone:201-753-3638
Mailing Address - Fax:201-449-0451
Practice Address - Street 1:455 COLONIAL TER
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1403
Practice Address - Country:US
Practice Address - Phone:201-753-3638
Practice Address - Fax:201-449-0451
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00764000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist