Healthcare Provider Details

I. General information

NPI: 1326765546
Provider Name (Legal Business Name): MERCY PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 N CHURCH ST
NAUGATUCK CT
06770-2845
US

IV. Provider business mailing address

577 N CHURCH ST
NAUGATUCK CT
06770-2845
US

V. Phone/Fax

Practice location:
  • Phone: 347-731-8420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ESTHER BLESSED AGYEMANG
Title or Position: OWNER
Credential: NP
Phone: 203-275-9874