Provider Demographics
NPI:1194701383
Name:ARNOLD, MERLA (PHD)
Entity type:Individual
Prefix:DR
First Name:MERLA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BENNETT AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2811
Mailing Address - Country:US
Mailing Address - Phone:631-271-8963
Mailing Address - Fax:
Practice Address - Street 1:13 BENNETT AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-2811
Practice Address - Country:US
Practice Address - Phone:631-271-8963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015276103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02358794Medicaid
NY02358794Medicaid