Provider Demographics
NPI:1619291119
Name:CORRAO, MEAGAN ANNE (DPT)
Entity Type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:ANNE
Last Name:CORRAO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MEAGAN
Other - Middle Name:ANNE
Other - Last Name:MACMENAMIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1061 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1853
Mailing Address - Country:US
Mailing Address - Phone:516-568-8585
Mailing Address - Fax:516-586-8586
Practice Address - Street 1:1061 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1853
Practice Address - Country:US
Practice Address - Phone:516-568-8585
Practice Address - Fax:516-586-8586
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist