Provider Demographics
NPI:1508549312
Name:MCCULLOUGH, MEGAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:MCCULLOUGH
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 1:45 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2043
Mailing Address - Country:US
Mailing Address - Phone:973-907-6582
Mailing Address - Fax:
Practice Address - Street 1:600 S WYCOMBE AVE
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-2835
Practice Address - Country:US
Practice Address - Phone:877-889-5188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist