Provider Demographics
NPI:1497799209
Name:MEYER, SHIRA A (DO)
Entity Type:Individual
Prefix:DR
First Name:SHIRA
Middle Name:A
Last Name:MEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225 WILLOW BROOK RD STE 9
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5922
Mailing Address - Country:US
Mailing Address - Phone:732-462-9622
Mailing Address - Fax:732-780-0014
Practice Address - Street 1:479 ROUTE 520
Practice Address - Street 2:SUITE 101A
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746
Practice Address - Country:US
Practice Address - Phone:732-780-1601
Practice Address - Fax:732-834-0438
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08074600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine