Provider Demographics
NPI:1205888930
Name:MEINEKE, ERIN C (PT, DPT, C/NDT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:C
Last Name:MEINEKE
Suffix:
Gender:F
Credentials:PT, DPT, C/NDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GARNET DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07438-9722
Mailing Address - Country:US
Mailing Address - Phone:973-906-0533
Mailing Address - Fax:
Practice Address - Street 1:400 MORRIS AVE STE 210
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1370
Practice Address - Country:US
Practice Address - Phone:973-298-0926
Practice Address - Fax:973-453-6330
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01083200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016806440003Medicaid
NJ057033-QHUMedicare ID - Type UnspecifiedGROUP NUMBER
PA0016806440003Medicaid