Healthcare Provider Details

I. General information

NPI: 1174625545
Provider Name (Legal Business Name): WALLACE P MERES AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

V A HUDSON VALLEY HEALTH CARE SYSTEM ALBANY POST ROAD
MONTROSE NY
10548
US

IV. Provider business mailing address

62 EAST RD
WALLKILL NY
12589
US

V. Phone/Fax

Practice location:
  • Phone: 845-838-5226
  • Fax: 845-838-5266
Mailing address:
  • Phone: 845-838-5226
  • Fax: 845-838-5266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number001614-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201000569
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number14000007194
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: