Basic Information
| Provider Information | |||||||||
| NPI: | 1649689373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THORNTON | ||||||||
| FirstName: | MERRY | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | PHYSICIAN ASSISTANT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 FLINTLOCK RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | KATONAH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105362508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146713134 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 E 55TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100224540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122833000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2014 | ||||||||
| LastUpdateDate: | 08/06/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 017766 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.