Provider Demographics
NPI:1811728397
Name:TRUONG, MEGHAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LYNNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2707
Mailing Address - Country:US
Mailing Address - Phone:732-289-0724
Mailing Address - Fax:
Practice Address - Street 1:12 LYNNWOOD RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2707
Practice Address - Country:US
Practice Address - Phone:732-289-0724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02192600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist