Doctor Name: | MEGAN OVERLAN |
NPI Number: | 1013321488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | P93224 |
Business Practice Address: | 3767 Delaware Ave Kenmore, NY - 142171040 |
Business Phone Number: | 7168746175 |
Business Fax Number: | |
Mailing Address: | 3767 Delaware Ave, KENMORE |
State: | NY |
Postal Code: | 142171040 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/13/2014 |
NPI Last Update Date: | 06/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | P93224 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |