Basic Information
| Provider Information | |||||||||
| NPI: | 1942383989 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEISLICH | ||||||||
| FirstName: | DEBRAH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 502 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8569636888 | ||||||||
| FaxNumber: | 8569688414 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422617 | ||||||||
| FaxNumber: | 8569688414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 04/25/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0208X | MA64853 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Infectious Diseases |
ID Information
| ID | Type | State | Issuer | Description | 1056001 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 3K5988 | 01 | NJ | HEALTHNET | OTHER | AETNA | 01 | NJ | 2969196 | OTHER | 3628440 | 01 | NJ | AETNA | OTHER | 5296803 | 05 | NJ | MEDICAID | 0371860000 | 01 | NJ | AMERIHEALTH/KEYSTON/IBC | OTHER | 954380 | 01 | NJ | AMERIHEALTH PPO/PA BS | OTHER | PHS623 | 01 | NJ | OXFORD | OTHER | 23159 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 2969196 | 01 | NJ | AETNA | OTHER | CA0000207 | 01 | NJ | AMERICHOICE | OTHER | 0888769 | 01 | NJ | CIGNA | OTHER | 1782784 | 01 | NJ | UNITED HEALTHCARE | OTHER |