Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22D101512800 | NJ |
NPI | 1003987454 |
---|---|
Provider Name | Dr. Brian J Meserlian |
First Address | Riverdale, NJ 07457-1625 |
Second Address | Riverdale, NJ 07457-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 27/01/2013 |