Provider Demographics
NPI:1932203577
Name:MERKEL, PAUL J (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:MERKEL
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:1404 PORTLAND AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621
Practice Address - Country:US
Practice Address - Phone:585-266-1940
Practice Address - Fax:585-266-2223
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN004993-1213E00000X
NY004993213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8146OtherBLUE CROSS/SHIELD
NY01532310Medicaid
NYMD486ROtherPREFERRED CARE
NYP010004993OtherBLUE CHOICE
NY8146OtherBLUE CROSS/SHIELD