1386136018 NPI number — MEGHAN CATHERINE REYNOLDS PT, DPT

Table of content: MEGHAN CATHERINE REYNOLDS PT, DPT (NPI 1386136018)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386136018 NPI number — MEGHAN CATHERINE REYNOLDS PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REYNOLDS
Provider First Name:
MEGHAN
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUMMEL
Provider Other First Name:
MEGHAN
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386136018
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
118 SHAWAN ROAD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
HUNT VALLEY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-628-7330
Provider Business Mailing Address Fax Number:
410-527-1729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 SHAWAN ROAD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
HUNT VALLEY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-628-7330
Provider Business Practice Location Address Fax Number:
410-527-1729
Provider Enumeration Date:
05/30/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  26013 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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