Provider Demographics
NPI:1205041142
Name:MELTZER, DARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARA
Middle Name:
Last Name:MELTZER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 W. 18TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-271-7260
Mailing Address - Fax:212-206-1085
Practice Address - Street 1:356 W. 18TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-271-7260
Practice Address - Fax:212-206-1085
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY54484-1183500000X
MA26042183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist