Provider Demographics
NPI:1083784532
Name:MERCHANT, BARRY (DC)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 LINDEN STREET
Mailing Address - Street 2:UNIT 5B
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-3959
Mailing Address - Country:US
Mailing Address - Phone:610-759-4321
Mailing Address - Fax:610-759-4396
Practice Address - Street 1:106 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064
Practice Address - Country:US
Practice Address - Phone:610-759-4321
Practice Address - Fax:610-759-4396
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002947L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
3767950OtherAETNA
50000380OtherCAPITAL BLUE CROSS
6439672001OtherCIGNA
P3576462OtherOXFORD
459356Medicare ID - Type Unspecified