Provider Demographics
NPI:1689068637
Name:MERCHANT, KUMAIL
Entity Type:Individual
Prefix:
First Name:KUMAIL
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 MINEOLA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2529
Mailing Address - Country:US
Mailing Address - Phone:516-663-9494
Mailing Address - Fax:516-663-2835
Practice Address - Street 1:173 MINEOLA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2529
Practice Address - Country:US
Practice Address - Phone:516-663-9494
Practice Address - Fax:516-663-2835
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2949912080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology