MEDICARE: MERAKEY NEW JERSEY

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1891352563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERAKEY NEW JERSEY

Provider Business Mailing Address
First Line	:	620 GERMANTOWN PIKE
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-1810
Country	:	US
Telephone Number	:	215-836-3131
Fax Number	:	215-273-5975

Provider Business Practice Location Address
First Line	:	1182 HEDDING RD
Second Line	:
City	:	COLUMBUS
State	:	NJ
Zip	:	08022-2059
Country	:	US
Telephone Number	:	215-836-3131
Fax Number	:	215-273-5975

Authorized Official
Title or Position	:	CORP SR DIRECTOR OF BUSINESS OPS
Name	:	MR. NORMAN E TILSON JR.
Credential	:
Telephone Number	:	215-836-3131

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	01/29/2024

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