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General NPI Number Information
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NPI Number | 1104363753
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Entity Type | Organization
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Legal Business Name | ISABEL MELTZER, CSW, PC
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 36 E 2ND ST
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City | RIVERHEAD
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State | NY
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Zip | 11901-4731
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Country | US
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Telephone | 631-208-9219
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Fax | 631-727-6605
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Provider Business Mailing Address
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Address Line | 36 E 2ND ST
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City | RIVERHEAD
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State | NY
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Zip | 11901-4731
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Country | US
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Telephone | 631-208-9219
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Fax | 631-727-6605
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Authorized Official
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Title or Position | PRESIDENT
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Name | ISABEL MELTZER
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Credential |
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Telephone | 631-208-9219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R045112
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License Number State | NY
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