=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548175797
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN MCCREEDY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2026
-----------------------------------------------------
Last Update Date | 08/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1450 CHAPEL ST
-----------------------------------------------------
City | NEW HAVEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06511-4405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-435-1161
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 59 HIGHVIEW AVE
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06460-7847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 010052
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------