Provider Demographics
NPI:1720109564
Name:MEYER, JAMES MICHAEL (RPAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:MEYER
Suffix:
Gender:M
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 GRAND STREET
Mailing Address - Street 2:JERSEY CITY MEDICAL CENTER
Mailing Address - City:JERSEY CITY
Mailing Address - State:NY
Mailing Address - Zip Code:07302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:355 GRAND STREET
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:JERSEY CITY
Practice Address - State:NY
Practice Address - Zip Code:07302
Practice Address - Country:US
Practice Address - Phone:201-915-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00018400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098641DEMMedicare PIN
S82877Medicare UPIN
P00393268Medicare PIN