Provider Demographics
NPI:1154328755
Name:MEYERS, MARTA (MD)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 MADISON AVE STE 405
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7336
Practice Address - Country:US
Practice Address - Phone:973-829-9998
Practice Address - Fax:973-829-9991
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05055700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJM2241005Medicaid
NJM2241005Medicaid
NJD94114Medicare UPIN