Provider Demographics
NPI:1326054990
Name:MAYER, ERIC (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MAYER
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 1:1521 8TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1893
Mailing Address - Country:US
Mailing Address - Phone:610-882-2598
Mailing Address - Fax:610-882-4443
Practice Address - Street 1:2 CAPITAL WAY STE 407
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-303-4460
Practice Address - Fax:609-303-4461
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421140208800000X
NJ25MA06869500208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101578625Medicaid
067848Medicare PIN
PAH79747Medicare UPIN