Provider Demographics
NPI:1548614787
Name:MEER, MARCELLE (DMD)
Entity Type:Individual
Prefix:
First Name:MARCELLE
Middle Name:
Last Name:MEER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARCELLE
Other - Middle Name:
Other - Last Name:HEFEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:814 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-729-7915
Mailing Address - Fax:
Practice Address - Street 1:814 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1002
Practice Address - Country:US
Practice Address - Phone:212-729-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY059593-11223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program