Healthcare Provider Details

I. General information

NPI: 1114300175
Provider Name (Legal Business Name): COUNTY OF MERCER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SCOTCH RD BLDG 1
EWING NJ
08628-1301
US

IV. Provider business mailing address

300 SCOTCH RD BLDG 1
EWING NJ
08628-1301
US

V. Phone/Fax

Practice location:
  • Phone: 609-530-1970
  • Fax: 609-530-7517
Mailing address:
  • Phone: 609-530-1970
  • Fax: 609-530-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MR. MARTIN J DENERO
Title or Position: DIRECTOR
Credential:
Phone: 609-530-1970