Provider Demographics
NPI:1093775116
Name:MEYER, DALE ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:ROBERT
Last Name:MEYER
Suffix:
Gender:M
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 700
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-0700
Mailing Address - Country:US
Mailing Address - Phone:518-533-6540
Mailing Address - Fax:518-533-6542
Practice Address - Street 1:1220 NEW SCOTLAND RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9208
Practice Address - Country:US
Practice Address - Phone:518-533-6540
Practice Address - Fax:518-533-6542
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182237207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY346079OtherMVP
NY10006067OtherCDPHP
VT1011585Medicaid
NY409B41OtherEMPIRE BC/BS
NY57709OtherGHI HMO
NY01196267Medicaid
NY0402099OtherGHI
NY040426006142OtherFIDELIS
NY000406789005OtherBLUE SHIELD NENY
VT1011585Medicaid
NY000406789005OtherBLUE SHIELD NENY