Provider Demographics
NPI:1366449050
Name:MELTZER, RICHARD B (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:MELTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:257 MONMOUTH RD
Mailing Address - Street 2:BLDG. A. SUITE 2
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1500
Mailing Address - Country:US
Mailing Address - Phone:732-531-6400
Mailing Address - Fax:732-517-0223
Practice Address - Street 1:257 MONMOUTH RD
Practice Address - Street 2:BLDG. A. SUITE 2
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1500
Practice Address - Country:US
Practice Address - Phone:732-531-6400
Practice Address - Fax:732-517-0223
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02777500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222307855OtherTAX ID
NJME420169Medicare ID - Type Unspecified
NJC54196Medicare UPIN