Provider Demographics
NPI:1487737599
Name:MEROLA, ARTHUR J (DPM)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:MEROLA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3710
Mailing Address - Country:US
Mailing Address - Phone:800-741-5273
Mailing Address - Fax:718-448-8041
Practice Address - Street 1:11 RALPH PL STE 314
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4420
Practice Address - Country:US
Practice Address - Phone:718-448-8040
Practice Address - Fax:718-448-8041
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNOO4960-1213E00000X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01648186Medicaid
NY01648186Medicaid
NYU45059Medicare UPIN