Provider Demographics
NPI:1104077791
Name:MEYER, ALLAN MICHAEL JR (OTR/L)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:MICHAEL
Last Name:MEYER
Suffix:JR
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8747
Mailing Address - Country:US
Mailing Address - Phone:516-220-2109
Mailing Address - Fax:347-802-4329
Practice Address - Street 1:59 MAPLE RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8747
Practice Address - Country:US
Practice Address - Phone:516-220-2109
Practice Address - Fax:347-802-4329
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009444-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist