Healthcare Provider Details

I. General information

NPI: 1043175482
Provider Name (Legal Business Name): MIREL MEISELS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 BRAMHALL AVE
JERSEY CITY NJ
07304-2335
US

IV. Provider business mailing address

831 BEDFORD AVE # 104
BROOKLYN NY
11205-2801
US

V. Phone/Fax

Practice location:
  • Phone: 484-201-7988
  • Fax: 484-861-2075
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: