Provider Demographics
NPI:1225393531
Name:MEEROVICH, ANATOLY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANATOLY
Middle Name:
Last Name:MEEROVICH
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 1:4982 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6399
Mailing Address - Country:US
Mailing Address - Phone:718-477-6900
Mailing Address - Fax:718-477-7862
Practice Address - Street 1:4982 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6399
Practice Address - Country:US
Practice Address - Phone:718-477-6900
Practice Address - Fax:718-477-7862
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280743207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine