Provider Demographics
NPI:1235339722
Name:MELTZ, MARCY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:
Last Name:MELTZ
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 1:1081 TULLO FARM RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2358
Mailing Address - Country:US
Mailing Address - Phone:908-229-6224
Mailing Address - Fax:
Practice Address - Street 1:800 RYDERS LANE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-432-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ038834207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH51233Medicare UPIN
NJ052473Medicare PIN
052473Medicare PIN
H51233Medicare UPIN