Provider Demographics
NPI:1326148990
Name:MELTZER, MARC JAY (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:JAY
Last Name:MELTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HICKSVILLE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2331
Practice Address - Country:US
Practice Address - Phone:631-953-4500
Practice Address - Fax:631-953-4570
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64690Medicare UPIN
NY89D961Medicare ID - Type Unspecified