Provider Demographics
NPI:1013345552
Name:MELTZER, SHARON R (PA)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:R
Last Name:MELTZER
Suffix:
Gender:
Credentials:PA
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 1:20 PROSPECT AVE STE 703
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1963
Practice Address - Country:US
Practice Address - Phone:551-996-4424
Practice Address - Fax:551-996-0831
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NJ25MP00325200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant