Healthcare Provider Details

I. General information

NPI: 1932203577
Provider Name (Legal Business Name): PAUL J MERKEL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 PORTLAND AVENUE
ROCHESTER NY
14621
US

IV. Provider business mailing address

908 NIAGARA FALLS BLVD STE 208
N TONAWANDA NY
14120
US

V. Phone/Fax

Practice location:
  • Phone: 585-266-1940
  • Fax: 585-266-2223
Mailing address:
  • Phone: 716-692-2160
  • Fax: 716-692-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004993-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number004993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: