Provider Demographics
NPI:1457550592
Name:POTNIS, MEGHANA ANIRUDDHA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MEGHANA
Middle Name:ANIRUDDHA
Last Name:POTNIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MEGHANA
Other - Middle Name:VASUDEO
Other - Last Name:KAVIMANDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2144 SUGAR MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1534
Mailing Address - Country:US
Mailing Address - Phone:610-831-2177
Mailing Address - Fax:
Practice Address - Street 1:5500 BROOKTREE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:724-940-3468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist