Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 152W00000X | Optometrist | | 27OA00427900 | NEW JERSEY | No |
| 2 | 152W00000X | Optometrist | | 27OA00426400 | NEW JERSEY | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | NJ04264 | OTHER | NEW JERSEY | VBA GROUP NUMBER |
| 2 | 2533201 | MEDICAID | NEW JERSEY | |
| 3 | 4501820 | OTHER | NEW JERSEY | DR. MELTZER AETNA ID |
| 4 | U02761 | MEDICARE UPIN | NEW JERSEY | |
| 5 | 3229106 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | OFFICE GROUP NUMBER |
| 6 | 6952208 | MEDICAID | NEW JERSEY | |
| 7 | 1117780001 | MEDICARE NSC | NEW JERSEY | |
| 8 | K16299 | OTHER | NEW JERSEY | DR. SHISSIAS HEALTHNET ID |
| 9 | EYEF01296 | OTHER | NEW JERSEY | SPECTERA GROUP NUMBER |
| 10 | 085288 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | OFFICE GROUP NUMBER |
| 11 | 085288 | MEDICARE PIN | NEW JERSEY | |
| 12 | 411769AK2 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | MICHAEL MELTZER OD |
| 13 | 503805AK2 | MEDICARE ID-TYPE UNSPECIFIED | NEW JERSEY | DEAN SHISSIAS OD |
| 14 | NJ4264 | OTHER | NEW JERSEY | EYEMED GROUP NUMBER |
| 15 | T84919 | MEDICARE UPIN | NEW JERSEY | |
