Provider Demographics
NPI:1710223276
Name:MEEHAN, DEANNA M (DPT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:M
Other - Last Name:PAONESSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11 EAGLE ROCK AVE.
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:
Practice Address - Street 1:1265 PATERSON PLANK ROAD
Practice Address - Street 2:SUITE 2C
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094
Practice Address - Country:US
Practice Address - Phone:201-583-6900
Practice Address - Fax:201-583-6901
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01404300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist