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NPI 1427413897

NPI 1427413897 : CHRISTOPHER MEOLA : RIVERDALE, NJ

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General NPI Number Information
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    NPI Number           |    1427413897
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER MEOLA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/29/2015
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    Last Update Date     |    12/29/2015
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Provider Practice Location Address
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    Address Line         |    6 N CORPORATE DR 
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    City                 |    RIVERDALE
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    State                |    NJ
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    Zip                  |    07457-1715
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    Country              |    US
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    Telephone            |    973-200-5848
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6 N CORPORATE DR 
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    City                 |    RIVERDALE
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    State                |    NJ
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    Zip                  |    07457-1715
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    Country              |    US
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    Telephone            |    973-200-5848
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225400000X
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    Taxonomy Name        |    Rehabilitation Practitioner
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    License Number       |    1481217
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    License Number State |    NJ
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