Provider Demographics
NPI:1063803450
Name:MONICA R. MEYER MD PC
Entity type:Organization
Organization Name:MONICA R. MEYER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-679-0100
Mailing Address - Street 1:5 PLAYHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-1609
Mailing Address - Country:US
Mailing Address - Phone:845-679-0100
Mailing Address - Fax:845-679-0400
Practice Address - Street 1:5 PLAYHOUSE LN
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1609
Practice Address - Country:US
Practice Address - Phone:845-679-0100
Practice Address - Fax:845-679-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1238152080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty