Provider Demographics
NPI:1386636900
Name:MEYER, MILTON A (DC)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:A
Last Name:MEYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4700
Mailing Address - Country:US
Mailing Address - Phone:212-254-5221
Mailing Address - Fax:212-254-6798
Practice Address - Street 1:425 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4700
Practice Address - Country:US
Practice Address - Phone:212-254-5221
Practice Address - Fax:212-254-6798
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX21271Medicare PIN