Provider Demographics
NPI:1295935732
Name:MUENZER, JAY TERRY
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:TERRY
Last Name:MUENZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 AMARILLO DR
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1305
Mailing Address - Country:US
Mailing Address - Phone:845-627-2267
Mailing Address - Fax:
Practice Address - Street 1:34 AMARILLO DR
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1305
Practice Address - Country:US
Practice Address - Phone:845-627-2267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02234800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist