Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 136631 | NY |
NPI | 1053308429 |
---|---|
Provider Name | Harold Mermelstein |
First Address | Scarsdale, NY 10583-3242 |
Second Address | Scarsdale, NY 10583-3242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 21/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00436219 | (05) | NY |
CO6361 | (02) | NY |