Provider Demographics
NPI:1659032753
Name:MELTZER, JILLIAN YETTA (LAC)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:YETTA
Last Name:MELTZER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COPPERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1781
Mailing Address - Country:US
Mailing Address - Phone:267-968-1479
Mailing Address - Fax:
Practice Address - Street 1:HAR SINAI 2
Practice Address - Street 2:
Practice Address - City:TEL AVIV
Practice Address - State:ISRAEL
Practice Address - Zip Code:6581602
Practice Address - Country:IL
Practice Address - Phone:052-705-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14596171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist