Healthcare Provider Details

I. General information

NPI: 1811162175
Provider Name (Legal Business Name): MERCER PRACTICE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 HIGHWAY 33
HAMILTON NJ
08690-1740
US

IV. Provider business mailing address

2131 HIGHWAY 33
HAMILTON NJ
08690-1740
US

V. Phone/Fax

Practice location:
  • Phone: 609-586-8498
  • Fax: 609-586-7876
Mailing address:
  • Phone: 609-586-8498
  • Fax: 609-586-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ANN ANGELO
Title or Position: MANAGER
Credential:
Phone: 609-586-8498