Provider Demographics
NPI:1346562519
Name:TREDER, MEGHAN EILEEN (PT, MSPT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:EILEEN
Last Name:TREDER
Suffix:
Gender:F
Credentials:PT, MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COURT ST
Mailing Address - Street 2:SUITE 12-10
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4859
Mailing Address - Country:US
Mailing Address - Phone:718-858-6546
Mailing Address - Fax:718-858-0165
Practice Address - Street 1:50 COURT ST
Practice Address - Street 2:SUITE 12-10
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4859
Practice Address - Country:US
Practice Address - Phone:718-858-6546
Practice Address - Fax:718-858-0165
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist