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NPI Code Detail

MEDICARE: DR. JOHN R. MEEHAN JR. DPT

MEDICARE: DR. JOHN R. MEEHAN JR. DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist007983CT

General Provider Information

NPI Number : 1134207012
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN R. MEEHAN JR. DPT
Provider Business Mailing Address
First Line : 1412 NEWFIELD AVE
Second Line :
City : STAMFORD
State : CT
Zip : 06905-1416
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 WEST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06850-4020
Country : US
Telephone Number : 203-852-9903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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