Provider Demographics
NPI:1134109754
Name:MERKLER, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MERKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 56TH ST
Mailing Address - Street 2:APARTMENT 6N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4147
Mailing Address - Country:US
Mailing Address - Phone:212-838-4715
Mailing Address - Fax:
Practice Address - Street 1:315 W 57TH ST
Practice Address - Street 2:STE 301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3148
Practice Address - Country:US
Practice Address - Phone:212-838-4715
Practice Address - Fax:212-586-2182
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134561173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00764549Medicaid
NYB20252Medicare UPIN
NY00764549Medicaid