Provider Demographics
NPI:1831590868
Name:CZERNIAK, MEGAN ELIZABETH (DPT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:CZERNIAK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:544 UNION AVE
Mailing Address - Street 2:APT 2W
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1209
Mailing Address - Country:US
Mailing Address - Phone:570-449-4464
Mailing Address - Fax:
Practice Address - Street 1:544 UNION AVE
Practice Address - Street 2:APT 2W
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1209
Practice Address - Country:US
Practice Address - Phone:570-449-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist