| | Physician Last Name: | Mervis |
| | Physician First Name: | Michael |
| | Physician Middle Name: | J |
| | Address: | 1382 Third Avenue
Apt.335
New York, New York 10021 |
| | License Number: | 218866 |
| | License Type: | MD |
| | Year of Birth: |
1972
|
| | Effective Date: | 03/23/2005 |
| | Action Description for DOH Webpage: | Temporary surrender of New York State medical license issued pursuant to New York State Public Health Law Section 230.13.The physician's current medical license status is inactive. |
| | Misconduct Description for DOH Webpage: | This action is not disciplinary in nature. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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