Provider Demographics
NPI:1134155039
Name:MEGNA, JAMES (PT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MEGNA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 LAKESIDE TRL
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-2246
Mailing Address - Country:US
Mailing Address - Phone:631-300-0769
Mailing Address - Fax:
Practice Address - Street 1:166 LAKESIDE TRL
Practice Address - Street 2:
Practice Address - City:RIDGE
Practice Address - State:NY
Practice Address - Zip Code:11961-2246
Practice Address - Country:US
Practice Address - Phone:631-300-0769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010950-12251N0400X
NY010950225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2468823OtherUNITED HEALTHCARE NUMBER
NY2468823OtherUNITED HEALTHCARE NUMBER