Provider Demographics
NPI:1831160100
Name:MEYER, BRUCE L (OD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:L
Last Name:MEYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2658
Mailing Address - Country:US
Mailing Address - Phone:201-265-7900
Mailing Address - Fax:201-265-7904
Practice Address - Street 1:1 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2658
Practice Address - Country:US
Practice Address - Phone:201-265-7900
Practice Address - Fax:201-265-7904
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00433600152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Not Answered152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Not Answered152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Not Answered152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Not Answered152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3362189OtherAETNA
NJ2K6333OtherHEALTH NET
NJ02000568260OtherUNITED HEALTH CARE
NJ3777107OtherCIGNA PPO
NJP2654429OtherOXFORD
NJ02000568260OtherUNITED HEALTH CARE
NJ3362189OtherAETNA