Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 147245 | NY |
NPI | 1003906025 |
---|---|
Provider Name | James Edward Meltzer |
First Address | Poughkeepsie, NY 12603 |
Second Address | Poughkeepsie, NY 12603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B10563 | (02) |