Provider Demographics
NPI:1871993071
Name:MERINO, NANYELY
Entity type:Individual
Prefix:
First Name:NANYELY
Middle Name:
Last Name:MERINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6017 HUDSON AVE APT 32
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-2890
Mailing Address - Country:US
Mailing Address - Phone:212-732-5427
Mailing Address - Fax:212-964-9607
Practice Address - Street 1:6017 HUDSON AVE
Practice Address - Street 2:APT. 32
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2865
Practice Address - Country:US
Practice Address - Phone:212-732-5427
Practice Address - Fax:212-964-9607
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator