Healthcare Provider Details

I. General information

NPI: 1588614796
Provider Name (Legal Business Name): KRZYSZTOF J MERKEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ELMWOOD AVENUE KENMORE MERCY HOSPITAL
KENMORE NY
14217
US

IV. Provider business mailing address

2333 ELMWOOD AVENUE SUITE 2
KENMORE NY
14217-2646
US

V. Phone/Fax

Practice location:
  • Phone: 716-447-6100
  • Fax:
Mailing address:
  • Phone: 716-874-1098
  • Fax: 716-874-9616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1995711
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: