Provider Demographics
NPI:1326226879
Name:MERVYN ROY KAPLAN
Entity Type:Organization
Organization Name:MERVYN ROY KAPLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MERVYN
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-681-8868
Mailing Address - Street 1:80 EAST HARTSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2810
Mailing Address - Country:US
Mailing Address - Phone:914-681-8868
Mailing Address - Fax:914-681-7162
Practice Address - Street 1:80 EAST HARTSDALE AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2810
Practice Address - Country:US
Practice Address - Phone:914-681-8868
Practice Address - Fax:914-681-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002253-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00405463Medicaid
NY0053184OtherGHI
NY154044OtherUNITED HEALTHCARE
NYP2571480OtherOXFORD
NYN69344OtherHEALTHNET
NYP25152OtherBLUE SHIELD
NY0890554OtherAETNA
NY0053184OtherGHI
NY00405463Medicaid
NYP25152Medicare PIN