Provider Demographics
NPI:1821094731
Name:MEYER, JOHN D (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 1057
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-241-5555
Mailing Address - Fax:212-241-5516
Practice Address - Street 1:1 GUSTAVE L LEVY PL # 1057
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-241-5555
Practice Address - Fax:212-241-5516
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2559512083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1399436Medicaid
CTD99886Medicare UPIN
CT110008457Medicare PIN