MEDICARE: SON CHU MEROLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	401725	NY

General Provider Information

NPI Number	:	1538577226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SON CHU MEROLA

Provider Business Mailing Address
First Line	:	267 SUNSET DR
Second Line	:
City	:	CORNING
State	:	NY
Zip	:	14830-2450
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 E MARKET ST # 203
Second Line	:
City	:	CORNING
State	:	NY
Zip	:	14830-2708
Country	:	US
Telephone Number	:	607-207-8799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2014
Last Update Date	:	03/17/2026

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Directions to “ SON CHU MEROLA ” Practice Location

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