Healthcare Provider Details

I. General information

NPI: 1619141207
Provider Name (Legal Business Name): MEGAN EGGLETON D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 STATE ROUTE 97 CALLICOON
CALLICOON NY
12723-5052
US

IV. Provider business mailing address

48 SCHAEFER RD JEFFERSONVILLE
JEFFERSONVILLE NY
12748-5830
US

V. Phone/Fax

Practice location:
  • Phone: 845-887-5530
  • Fax: 845-887-4656
Mailing address:
  • Phone: 845-887-5530
  • Fax: 845-887-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number62-029969
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: