Provider Demographics
NPI:1912221524
Name:ATLANTIC HEALTH
Entity Type:Organization
Organization Name:ATLANTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-971-7803
Mailing Address - Street 1:242 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4109
Mailing Address - Country:US
Mailing Address - Phone:201-881-6864
Mailing Address - Fax:201-886-8334
Practice Address - Street 1:242 WARREN AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4109
Practice Address - Country:US
Practice Address - Phone:201-881-6864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08601600282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren