Provider Demographics
NPI:1508927690
Name:MELTZER, DANIEL STEPHEN (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEPHEN
Last Name:MELTZER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 ROUTE 1 AND GILL LANE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830
Mailing Address - Country:US
Mailing Address - Phone:732-636-7444
Mailing Address - Fax:732-636-5472
Practice Address - Street 1:675 RT.1 AND GILL LN.
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830
Practice Address - Country:US
Practice Address - Phone:732-636-7444
Practice Address - Fax:732-636-5472
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00441500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0490105Medicaid
NJ0490105Medicaid
NJU02566Medicare UPIN