Provider Demographics
NPI:1639281603
Name:FORSATZ, MEGHAN D (DPT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:D
Last Name:FORSATZ
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 1:1719 ROUTE 10 STE 117
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4507
Mailing Address - Country:US
Mailing Address - Phone:201-638-7378
Mailing Address - Fax:
Practice Address - Street 1:1719 ROUTE 10 STE 117
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4507
Practice Address - Country:US
Practice Address - Phone:201-638-7378
Practice Address - Fax:201-623-3696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01217200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist