Basic Information
| Provider Information | |||||||||
| NPI: | 1427054659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEROLA | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 68 SOUTH SERVICE ROAD, | ||||||||
| Address2: | SUITE 350 NORTH AMERICAN PARTNERS IN ANESTHESIA, LLP | ||||||||
| City: | MELVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117470000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169453000 | ||||||||
| FaxNumber: | 5169453131 | ||||||||
| Practice Location | |||||||||
| Address1: | 270-05 76TH AVENUE | ||||||||
| Address2: | DEPARTMENT OF ANESTHESIA | ||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184707390 | ||||||||
| FaxNumber: | 7184706307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2005 | ||||||||
| LastUpdateDate: | 12/01/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 173510 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 01190867 | 05 | NY | MEDICAID |