Provider Demographics
NPI:1922183573
Name:MEYERSON, STEVEN JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JEFFREY
Last Name:MEYERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-8236
Mailing Address - Country:US
Mailing Address - Phone:201-788-9744
Mailing Address - Fax:
Practice Address - Street 1:104 BROOKVIEW DR
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-8236
Practice Address - Country:US
Practice Address - Phone:201-788-9744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA070817002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0099147Medicaid
NJH23303Medicare UPIN