MEDICARE: MERCEDES QUENTASIA-DENISE HARRIS CRNP, AGPCNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	SP033906	PA

General Provider Information

NPI Number	:	1760357081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCEDES QUENTASIA-DENISE HARRIS CRNP, AGPCNP-BC

Provider Business Mailing Address
First Line	:	2 UNIVERSITY PLZ STE 204
Second Line	:
City	:	HACKENSACK
State	:	NJ
Zip	:	07601-6211
Country	:	US
Telephone Number	:	551-295-8223
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 GREENWOOD AVE STE 140
Second Line	:
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-2627
Country	:	US
Telephone Number	:	215-238-6300
Fax Number	:	484-352-2283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	01/29/2026

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