Provider Demographics
NPI:1669641494
Name:PRICE, MEREDITH (PTA)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5913
Mailing Address - Country:US
Mailing Address - Phone:732-224-9355
Mailing Address - Fax:732-224-1317
Practice Address - Street 1:315 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5913
Practice Address - Country:US
Practice Address - Phone:732-224-9355
Practice Address - Fax:732-224-1317
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00209400225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant