Provider Demographics
NPI:1376632414
Name:MEYER, DANIEL ARTHUR (PH D)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ARTHUR
Last Name:MEYER
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CEDAR COURT
Mailing Address - Street 2:
Mailing Address - City:MARLBARO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746
Mailing Address - Country:US
Mailing Address - Phone:732-431-6600
Mailing Address - Fax:732-845-1060
Practice Address - Street 1:22 CEDAR COURT
Practice Address - Street 2:
Practice Address - City:MARLBARO
Practice Address - State:NJ
Practice Address - Zip Code:07746
Practice Address - Country:US
Practice Address - Phone:732-431-6600
Practice Address - Fax:732-845-1060
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35510022800103TC0700X
NY0094031103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6828507Medicaid
NJ6828507Medicaid
NJ575826Medicare ID - Type Unspecified