Provider Demographics
NPI:1164486866
Name:MERRITT B WHITE DO PC
Entity Type:Organization
Organization Name:MERRITT B WHITE DO PC
Other - Org Name:BRIDGEHAMPTON FAMILY MEDICAL PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MERRITT
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-537-3765
Mailing Address - Street 1:PO BOX 3042
Mailing Address - Street 2:
Mailing Address - City:BRIDGEHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11932
Mailing Address - Country:US
Mailing Address - Phone:631-537-3765
Mailing Address - Fax:631-537-4296
Practice Address - Street 1:386 MONTAWK HIGHWAY
Practice Address - Street 2:SUITE 5
Practice Address - City:WAINSCOTT
Practice Address - State:NY
Practice Address - Zip Code:11975
Practice Address - Country:US
Practice Address - Phone:631-537-3765
Practice Address - Fax:631-537-4296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty