Provider Demographics
NPI:1679530901
Name:MERKER-LEVY, JESSICA FARA (DPM)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:FARA
Last Name:MERKER-LEVY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:FARA
Other - Last Name:MERKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:532 OLD SHORT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-467-9011
Mailing Address - Fax:973-467-9012
Practice Address - Street 1:532 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078
Practice Address - Country:US
Practice Address - Phone:973-467-9011
Practice Address - Fax:973-467-9012
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00276900213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V00319Medicare UPIN
NJ080585RICMedicare ID - Type Unspecified