Healthcare Provider Details

I. General information

NPI: 1447987599
Provider Name (Legal Business Name): DAVID MEROLLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 SOUTHBRIDGE ST
AUBURN MA
01501-2270
US

IV. Provider business mailing address

567 SOUTHBRIDGE ST
AUBURN MA
01501-2270
US

V. Phone/Fax

Practice location:
  • Phone: 401-864-8374
  • Fax:
Mailing address:
  • Phone: 401-864-8374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: