Provider Demographics
NPI:1548543671
Name:PITTER, MEGHAN (DPT)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:PITTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 YORK AVE
Mailing Address - Street 2:APT 14N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6342
Mailing Address - Country:US
Mailing Address - Phone:413-244-0168
Mailing Address - Fax:
Practice Address - Street 1:420 E 70TH ST
Practice Address - Street 2:APT 14P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5320
Practice Address - Country:US
Practice Address - Phone:413-244-0168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist