Provider Demographics
NPI:1083280515
Name:MERINO, KARLA PAMELA
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:PAMELA
Last Name:MERINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 HOBSON ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1322
Mailing Address - Country:US
Mailing Address - Phone:862-255-0483
Mailing Address - Fax:
Practice Address - Street 1:150 HOBSON ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-1322
Practice Address - Country:US
Practice Address - Phone:862-255-0483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst