Provider Demographics
NPI:1457603250
Name:MELTZER, PERRY JOSH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:JOSH
Last Name:MELTZER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 COMMUNITY DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3803
Mailing Address - Country:US
Mailing Address - Phone:516-603-4600
Mailing Address - Fax:
Practice Address - Street 1:444 COMMUNITY DR
Practice Address - Street 2:SUITE 307
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3803
Practice Address - Country:US
Practice Address - Phone:516-603-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020182103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical