MEDICARE: DR. MERRITT RICHARD HAIT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	202C00000X	Independent Medical Examiner Physician	094603	NY

General Provider Information

NPI Number	:	1912109703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERRITT RICHARD HAIT MD

Provider Business Mailing Address
First Line	:	307 5TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-6517
Country	:	US
Telephone Number	:	212-981-3400
Fax Number	:	212-981-3415

Provider Business Practice Location Address
First Line	:	307 5TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-6517
Country	:	US
Telephone Number	:	212-981-3400
Fax Number	:	212-981-3415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	07/08/2007

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