Provider Demographics
NPI:1538139613
Name:MELTZER, LEWIS HOWARD (MED)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:HOWARD
Last Name:MELTZER
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 GLEN ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2611
Mailing Address - Country:US
Mailing Address - Phone:610-896-8822
Mailing Address - Fax:
Practice Address - Street 1:515 GLEN ARBOR DR
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2611
Practice Address - Country:US
Practice Address - Phone:610-896-8822
Practice Address - Fax:610-896-3199
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS000221L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist