Provider Demographics
NPI:1558541953
Name:RUDOLF KURT MEIER III
Entity Type:Organization
Organization Name:RUDOLF KURT MEIER III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUDOLF
Authorized Official - Middle Name:KURT
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:III
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-899-4493
Mailing Address - Street 1:2095 ROUTE 88 E
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3265
Mailing Address - Country:US
Mailing Address - Phone:732-899-4493
Mailing Address - Fax:732-899-6801
Practice Address - Street 1:2095 ROUTE 88 E
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3265
Practice Address - Country:US
Practice Address - Phone:732-899-4493
Practice Address - Fax:732-899-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00205500213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0596100001Medicare NSC