Provider Demographics
NPI:1972778116
Name:RICHARD B. MELTZER MD PA
Entity Type:Organization
Organization Name:RICHARD B. MELTZER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-531-6400
Mailing Address - Street 1:257 MONMOUTH RD
Mailing Address - Street 2:BLDG A SUITE 2
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1500
Mailing Address - Country:US
Mailing Address - Phone:732-531-6400
Mailing Address - Fax:732-517-0223
Practice Address - Street 1:257 MONMOUTH RD
Practice Address - Street 2:BLDG A SUITE 2
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1500
Practice Address - Country:US
Practice Address - Phone:732-531-6400
Practice Address - Fax:732-517-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME420169Medicare PIN
C54196Medicare UPIN