Provider Demographics
NPI:1629488440
Name:MERMELSTEIN, RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:MERMELSTEIN
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 1:15 SMITH PLACE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596
Mailing Address - Country:US
Mailing Address - Phone:718-806-1434
Mailing Address - Fax:718-806-1435
Practice Address - Street 1:225 NASSAU BLVD # B
Practice Address - Street 2:
Practice Address - City:W HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2247
Practice Address - Country:US
Practice Address - Phone:516-656-1919
Practice Address - Fax:833-968-3330
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY290500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine