Provider Demographics
NPI:1053982173
Name:EDWARDS, MEGAN (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:WAPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:178 N 11TH ST APT 6F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1134
Mailing Address - Country:US
Mailing Address - Phone:414-943-3312
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 215
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3247
Practice Address - Country:US
Practice Address - Phone:917-494-4284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist