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General NPI Number Information
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NPI Number | 1871940874
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Entity Type | Individual
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Provider Name | MEGHAN MIZRACHI P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 1556 3RD AVE STE 211
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City | NEW YORK
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State | NY
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Zip | 10128-3100
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Country | US
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Telephone | 212-353-8693
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Fax | 347-507-5510
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Provider Business Mailing Address
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Address Line | 525 WASHINGTON BLVD CLUB METRO
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1606
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Country | US
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Telephone | 201-473-4654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01709300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 040132
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License Number State | NY
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