Healthcare Provider Details

I. General information

NPI: 1104987866
Provider Name (Legal Business Name): DEBORAH L METZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 JAMES ST
EDISON NJ
08820-3947
US

IV. Provider business mailing address

65 JAMES ST
EDISON NJ
08820-3947
US

V. Phone/Fax

Practice location:
  • Phone: 732-321-7493
  • Fax:
Mailing address:
  • Phone: 732-321-7493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA2507526800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: