MEDICARE: DR. DALE ROBERT MEYER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	182237	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	346079	OTHER	NY	MVP
2	10006067	OTHER	NY	CDPHP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	409B41	OTHER	NY	EMPIRE BC/BS
5	57709	OTHER	NY	GHI HMO
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	0402099	OTHER	NY	GHI
8	040426006142	OTHER	NY	FIDELIS
9	000406789005	OTHER	NY	BLUE SHIELD NENY

General Provider Information

NPI Number	:	1093775116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE ROBERT MEYER MD

Provider Business Mailing Address
First Line	:	PO BOX 700
Second Line	:
City	:	SLINGERLANDS
State	:	NY
Zip	:	12159-0700
Country	:	US
Telephone Number	:	518-533-6540
Fax Number	:	518-533-6542

Provider Business Practice Location Address
First Line	:	1220 NEW SCOTLAND RD
Second Line	:	SUITE 302
City	:	SLINGERLANDS
State	:	NY
Zip	:	12159-9208
Country	:	US
Telephone Number	:	518-533-6540
Fax Number	:	518-533-6542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/24/2007

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Directions to “ DR. DALE ROBERT MEYER MD” Practice Location

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