National Provider Identifier
Carlos Jose Merino Gualan, MD
Carlos Jose Merino Gualan, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 859-4711.
Profile Overview
- NPI
- 1649844010
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- May 19, 2021
- Last Updated
- June 20, 2024
Practice Location
- 100 High St # B614
- Buffalo, NY 14203-1126
Phone: (716) 859-4711
Mailing Address
- 34 Maple Street
- Department Of Medicine
- Norwalk, CT 06850
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1649844010
- Entity Type
- Individual
- Last Name
- Merino Gualan
- First Name
- Carlos
- Middle Name
- Jose
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 34 Maple Street
- Mailing Address Line 2
- Department Of Medicine
- Mailing City
- Norwalk
- Mailing State
- CT
- Mailing ZIP Code
- 06850
- Mailing Country
- US
- Mailing Phone
- (203) 852-2303
- Mailing Fax
- (203) 899-5224
- Practice Street Address
- 100 High St # B614
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14203-1126
- Practice Country
- US
- Practice Phone
- (716) 859-4711
- Practice Fax
- (716) 859-2931
- Enumeration Date
- May 19, 2021
- Last Updated
- June 20, 2024
- Deactivation Date
- November 03, 2022
- Reactivation Date
- February 20, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- June 20, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)