Healthcare Provider Details

I. General information

NPI: 1588653109
Provider Name (Legal Business Name): EDWARD L. MERKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 MARBLE AVE
PLEASANTVILLE NY
10570-3424
US

IV. Provider business mailing address

2649 STRANG BLVD STE 304
YORKTOWN HEIGHTS NY
10598-2938
US

V. Phone/Fax

Practice location:
  • Phone: 914-769-7300
  • Fax: 914-769-7328
Mailing address:
  • Phone: 914-739-0087
  • Fax: 914-737-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number163291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: