Healthcare Provider Details

I. General information

NPI: 1235365198
Provider Name (Legal Business Name): JEFFREY MERKLE MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 MOUNTAIN AVE SUITE 304
HACKETTSTOWN NJ
07840-2407
US

IV. Provider business mailing address

254B MOUNTAIN AVE SUITE 304
HACKETTSTOWN NJ
07840-2407
US

V. Phone/Fax

Practice location:
  • Phone: 908-852-6400
  • Fax: 908-852-6450
Mailing address:
  • Phone: 908-852-6400
  • Fax: 908-852-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07799200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA07799200
License Number StateNJ

VIII. Authorized Official

Name: DR. JEFFREY MERKLE
Title or Position: OWNER/MD
Credential: MD
Phone: 908-852-6400