=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720157407
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLAN MARTIN MEYER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 532 NEPTUNE AVE SUITE 209
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11224-4010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-449-8860
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 136 GIRARD ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11235-3010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-934-7223
-----------------------------------------------------
Fax | 718-934-7223
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 153643
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------