Provider Demographics
NPI:1619141207
Name:EGGLETON, MEGAN (DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:EGGLETON
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 1:48 SCHAEFER RD
Mailing Address - Street 2:JEFFERSONVILLE
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12748-5830
Mailing Address - Country:US
Mailing Address - Phone:845-887-5530
Mailing Address - Fax:845-887-4656
Practice Address - Street 1:8881 STATE ROUTE 97
Practice Address - Street 2:CALLICOON
Practice Address - City:CALLICOON
Practice Address - State:NY
Practice Address - Zip Code:12723-5052
Practice Address - Country:US
Practice Address - Phone:845-887-5530
Practice Address - Fax:845-887-4656
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62-029969225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist