Healthcare Provider Details

I. General information

NPI: 1588928055
Provider Name (Legal Business Name): MERK PHARMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 3RD AVE
BRONX NY
10454-1199
US

IV. Provider business mailing address

2604 3RD AVE
BRONX NY
10454-1199
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-6500
  • Fax: 718-401-6502
Mailing address:
  • Phone: 718-401-6500
  • Fax: 718-401-6502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number031698
License Number StateNY

VIII. Authorized Official

Name: ANIL PULIGILLA
Title or Position: PHARMACIST
Credential:
Phone: 718-401-6500