Healthcare Provider Details

I. General information

NPI: 1922173350
Provider Name (Legal Business Name): MICHAEL MERENSTEIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 FIELDSTON RD SUITE 1J
BRONX NY
10463-2034
US

IV. Provider business mailing address

3636 FIELDSTON RD SUITE 1J
BRONX NY
10463-2034
US

V. Phone/Fax

Practice location:
  • Phone: 718-548-6732
  • Fax: 718-548-3819
Mailing address:
  • Phone: 718-548-6732
  • Fax: 718-548-3819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberN003955
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: