Provider Demographics
NPI:1083604011
Name:MEYER, JOY L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:L
Last Name:MEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-0461
Mailing Address - Country:US
Mailing Address - Phone:518-234-2868
Mailing Address - Fax:518-234-0098
Practice Address - Street 1:197 ELM ST
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-4681
Practice Address - Country:US
Practice Address - Phone:518-234-2868
Practice Address - Fax:518-234-0098
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183252208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01770745Medicaid
NY56692BMedicare ID - Type Unspecified
NY01770745Medicaid