Provider Demographics
NPI:1568854586
Name:GEBERT, MEGAN ANNE (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ANNE
Last Name:GEBERT
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:ANNE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:13 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CORNWALL ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12520-1312
Mailing Address - Country:US
Mailing Address - Phone:845-926-0479
Mailing Address - Fax:
Practice Address - Street 1:50 CROSS RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-6009
Practice Address - Country:US
Practice Address - Phone:845-236-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY71571842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer