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General NPI Number Information
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NPI Number | 1952467128
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Entity Type | Individual
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Provider Name | PHILIP MELTZER O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 80 MIDDLE NECK RD
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City | GREAT NECK
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State | NY
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Zip | 11021-1243
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Country | US
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Telephone | 516-487-3074
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Fax | 516-487-2581
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Provider Business Mailing Address
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Address Line | 2978 HEWLETT AVE
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City | MERRICK
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State | NY
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Zip | 11566-5311
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Country | US
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Telephone | 516-867-2020
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Fax | 516-487-2581
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T-004437-1
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License Number State | NY
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