Individual
KERRI-ANN MEGNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
130 LAKE AVE S, NESCONSET, NY 11767-1001
(631) 636-0620
Mailing address
23 GEMINI LN, NESCONSET, NY 11767-1707
(631) 780-6998
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002200-1
NY
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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