Provider Demographics
NPI:1659654341
Name:MERRIMAN, DONALD E JR (PHD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:MERRIMAN
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LILAC LN
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2746
Mailing Address - Country:US
Mailing Address - Phone:845-260-1292
Mailing Address - Fax:
Practice Address - Street 1:351 MANVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2152
Practice Address - Country:US
Practice Address - Phone:845-260-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019642103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist