Provider Demographics
NPI:1528202488
Name:GACHETTE, MEGON MELECIA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MEGON
Middle Name:MELECIA
Last Name:GACHETTE
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 1:46 BAME AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1302
Mailing Address - Country:US
Mailing Address - Phone:716-832-8780
Mailing Address - Fax:
Practice Address - Street 1:46 BAME AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1302
Practice Address - Country:US
Practice Address - Phone:716-832-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist