Individual
MEGAN GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
59 LANDING AVE STE 4, SMITHTOWN, NY 11787-2749
(631) 361-5111
(631) 366-2536
Mailing address
59 LANDING AVE STE 4, SMITHTOWN, NY 11787-2749
(631) 361-5111
(631) 366-2536
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
045165-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
NY
Enumeration date
11/20/2019
Last updated
11/20/2019
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