Provider Demographics
NPI:1811082894
Name:MAYER, FREDERICK G (DC)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:G
Last Name:MAYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON BY THE SEA
Mailing Address - State:NJ
Mailing Address - Zip Code:07717-1018
Mailing Address - Country:US
Mailing Address - Phone:732-988-8596
Mailing Address - Fax:
Practice Address - Street 1:508 MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON BY THE SEA
Practice Address - State:NJ
Practice Address - Zip Code:07717-1018
Practice Address - Country:US
Practice Address - Phone:732-988-8596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00341500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT45350Medicare UPIN
NJMA453734Medicare PIN