Provider Demographics
NPI:1508994898
Name:MERLINO, PHYLLIS GINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:GINA
Last Name:MERLINO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 TODT HILL RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5532
Mailing Address - Country:US
Mailing Address - Phone:718-761-2090
Mailing Address - Fax:
Practice Address - Street 1:268 TODT HILL RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5532
Practice Address - Country:US
Practice Address - Phone:718-761-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0453811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry