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General NPI Number Information
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NPI Number | 1538306212
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Entity Type | Organization
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Legal Business Name | JAY MERMELSTEIN, DPM.PC
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 105 STEVENS AVE SUITE 301
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2686
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Country | US
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Telephone | 914-699-1515
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Fax | 914-699-2907
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Provider Business Mailing Address
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Address Line | 105 STEVENS AVE SUITE 301
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2686
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Country | US
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Telephone | 914-699-1515
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Fax | 914-699-2907
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Authorized Official
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Title or Position | OWNER
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Name | JAY MERMELSTEIN
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Credential |
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Telephone | 914-699-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | N004414
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License Number State | NY
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