Provider Demographics
NPI:1235512476
Name:MELTZER, ERICA (OTR)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MELTZER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 CLAREMONT AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-1850
Mailing Address - Country:US
Mailing Address - Phone:201-919-8916
Mailing Address - Fax:
Practice Address - Street 1:135 COLUMBIA TPKE
Practice Address - Street 2:SUITE 302
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2104
Practice Address - Country:US
Practice Address - Phone:917-922-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00647100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist