Provider Demographics
NPI:1588614796
Name:MERKEL, KRZYSZTOF J (MD)
Entity Type:Individual
Prefix:
First Name:KRZYSZTOF
Middle Name:J
Last Name:MERKEL
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 1:2333 ELMWOOD AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2646
Mailing Address - Country:US
Mailing Address - Phone:716-874-1098
Mailing Address - Fax:716-874-9616
Practice Address - Street 1:2950 ELMWOOD AVENUE
Practice Address - Street 2:KENMORE MERCY HOSPITAL
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-447-6100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1995711207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011177002OtherUNIVERA
NY01843301Medicaid
2008199OtherINDEPENDENT HEALTH
NY000524238001OtherBLUE CROSS
2008199OtherINDEPENDENT HEALTH
G27801Medicare UPIN