Provider Demographics
NPI:1942383989
Name:MEISLICH, DEBRAH (MD)
Entity Type:Individual
Prefix:
First Name:DEBRAH
Middle Name:
Last Name:MEISLICH
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 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-963-6888
Mailing Address - Fax:856-968-8414
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-2617
Practice Address - Fax:856-968-8414
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA648532080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1056001OtherHORIZON NJ HEALTH
NJ3K5988OtherHEALTHNET
NJAETNAOther2969196
NJ3628440OtherAETNA
NJ5296803Medicaid
NJ0371860000OtherAMERIHEALTH/KEYSTON/IBC
NJ954380OtherAMERIHEALTH PPO/PA BS
NJPHS623OtherOXFORD
NJ23159OtherUNIVERSITY HEALTH PLAN
NJ2969196OtherAETNA
NJCA0000207OtherAMERICHOICE
NJ0888769OtherCIGNA
NJ1782784OtherUNITED HEALTHCARE
NJ3K5988OtherHEALTHNET
D87808Medicare UPIN