Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 203037 | NY |
NPI | 1326062332 |
---|---|
Provider Name | Dr. Laurence Eric Mermelstein |
First Address | Commack, NY 11725-3131 |
Second Address | Commack, NY 11725-3131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 28/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G18885 | (02) | NY |