Doctor Name: | MERSON SAMUEL |
NPI Number: | 1174643654 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F303651 |
Business Practice Address: | 119 Fulton Ave Garden City Park, NY - 110405305 |
Business Phone Number: | 5168778052 |
Business Fax Number: | |
Mailing Address: | 972 Brush Hollow Rd, WESTBURY |
State: | NY |
Postal Code: | 115901740 |
Phone Number: | 5168765555 |
Fax Number: | 5168761246 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 11/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F303651 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |