MEDICARE: MONICA RUTH 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	208000000X	Pediatrics Physician	123815	NY
2	2080A0000X	Pediatric Adolescent Medicine Physician	123815	NY
3	2080P0006X	Developmental - Behavioral Pediatrics Physician	123815	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447244520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA RUTH MEYER MD

Provider Business Mailing Address
First Line	:	9 ELWYN LANE
Second Line	:
City	:	WOODSTOCK
State	:	NY
Zip	:	12498-1301
Country	:	US
Telephone Number	:	845-679-0100
Fax Number	:	845-679-3324

Provider Business Practice Location Address
First Line	:	9 ELWYN LANE
Second Line	:
City	:	WOODSTOCK
State	:	NY
Zip	:	12498-1301
Country	:	US
Telephone Number	:	845-679-0100
Fax Number	:	845-679-3324

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	08/24/2013

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Directions to “ MONICA RUTH MEYER MD” Practice Location

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