Provider Demographics
NPI:1548442155
Name:MERKLE, ALFONS G (RPH)
Entity type:Individual
Prefix:MR
First Name:ALFONS
Middle Name:G
Last Name:MERKLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2415
Mailing Address - Country:US
Mailing Address - Phone:212-943-3690
Mailing Address - Fax:
Practice Address - Street 1:67 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2415
Practice Address - Country:US
Practice Address - Phone:212-943-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist