Basic Information
| Provider Information | |||||||||
| NPI: | 1033238571 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEIER | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | DANA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 195 LITTLE ALBANY STREET, ROOM 3507 | ||||||||
| Address2: | CANCER INSTITUTE OF NEW JERSEY | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322358557 | ||||||||
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| Practice Location | |||||||||
| Address1: | 195 LITTLE ALBANY ST | ||||||||
| Address2: | CANCER INSTITUTE OF NEW JERSEY, ROOM 3507 | ||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322358557 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 06/08/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0207X | 25MA08430300 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology |
ID Information
| ID | Type | State | Issuer | Description | 0178641 | 05 | NJ | MEDICAID |