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NPI Code Detail

MEDICARE: GREGORY MEYLIKER OPTICIAN

MEDICARE:   GREGORY  MEYLIKER  OPTICIAN
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
1156FX1800XOptician31TD00343500NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131TD00343500OTHERNJOPTICIAN LICIENSE

General Provider Information

NPI Number : 1902054380
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY MEYLIKER OPTICIAN
Provider Business Mailing Address
First Line : 2151 LEMOINE AVE
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-6041
Country : US
Telephone Number : 201-242-0300
Fax Number :
Provider Business Practice Location Address
First Line : 2151 LEMOINE AVE
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-6041
Country : US
Telephone Number : 201-242-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2008
Last Update Date : 08/28/2008

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Directions to “ GREGORY MEYLIKER OPTICIAN” Practice Location

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