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NPI Code Detail

MEDICARE: DR. MEGAN MCCULLOUGH DPT

MEDICARE: DR. MEGAN MCCULLOUGH 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 Therapist

General Provider Information

NPI Number : 1508549312
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGAN MCCULLOUGH DPT
Provider Business Mailing Address
First Line : 45 HARRISON AVE
Second Line :
City : MONTCLAIR
State : NJ
Zip : 07042-2043
Country : US
Telephone Number : 973-907-6582
Fax Number :
Provider Business Practice Location Address
First Line : 600 S WYCOMBE AVE
Second Line :
City : YEADON
State : PA
Zip : 19050-2835
Country : US
Telephone Number : 877-889-5188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2023
Last Update Date : 08/09/2023

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