Provider Demographics
NPI:1275719130
Name:MELTZER EYE CARE CENTER PA
Entity Type:Organization
Organization Name:MELTZER EYE CARE CENTER PA
Other - Org Name:MELTZER EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-636-7444
Mailing Address - Street 1:675 US HIGHWAY 1 S
Mailing Address - Street 2:SUITE 13
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3152
Mailing Address - Country:US
Mailing Address - Phone:732-636-7444
Mailing Address - Fax:732-636-5472
Practice Address - Street 1:675 ROUTE 1 S
Practice Address - Street 2:SUITE 13
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3152
Practice Address - Country:US
Practice Address - Phone:732-636-7444
Practice Address - Fax:732-636-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NJ270A00441500332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2925401Medicaid
NJU02556Medicare UPIN
NJ203779Medicare PIN
NJ2925401Medicaid
NJ0994600001Medicare NSC