Provider Demographics
NPI:1700423977
Name:LESNIAK, MEAGAN
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:LESNIAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-3560
Mailing Address - Country:US
Mailing Address - Phone:609-203-9229
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE PLAINS RD STE 230
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5838
Practice Address - Country:US
Practice Address - Phone:914-418-5266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist