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General NPI Number Information
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NPI Number | 1407254659
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Entity Type | Individual
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Provider Name | JAIME MEROLA LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 2626 75TH STREET LEXINGTON CENTER FOR MH CENTER
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City | EAST ELMHURST
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State | NY
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Zip | 11370
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Country | US
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Telephone | 718-350-3158
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Fax | 718-350-3067
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Provider Business Mailing Address
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Address Line | 6813 OWLS HEAD CT
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City | BROOKLYN
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State | NY
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Zip | 11220-5032
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Country | US
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Telephone | 347-838-0729
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Fax | 718-350-3067
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 088898
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License Number State | NY
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