Provider Demographics
NPI:1922014190
Name:MEYERS, JENNIFER LAUNDY (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUNDY
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:EASTON
Other - Last Name:LAUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:164 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-9575
Mailing Address - Country:US
Mailing Address - Phone:315-824-4600
Mailing Address - Fax:315-824-8447
Practice Address - Street 1:164 BROAD ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-9575
Practice Address - Country:US
Practice Address - Phone:315-824-4600
Practice Address - Fax:315-824-8447
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078103208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02899232Medicaid
MI4632435Medicaid
MIOH16103373Medicare ID - Type Unspecified
I18195Medicare UPIN