Individual
DR. MERRITT DREW KINON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467
(718) 920-7400
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-7400
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
253201
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDICAID
04230599
NY
Enumeration date
07/05/2011
Last updated
10/29/2020
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