Provider Demographics
NPI:1013345552
Name:MELTZER, SHARON
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:MELTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 2ND ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-2748
Mailing Address - Country:US
Mailing Address - Phone:845-641-9183
Mailing Address - Fax:
Practice Address - Street 1:230 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1529
Practice Address - Country:US
Practice Address - Phone:973-744-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant