Healthcare Provider Details

I. General information

NPI: 1467538108
Provider Name (Legal Business Name): MERCY A KURIYAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE ROBERT WOOD PLACE ROOM 232 MEB
NEW BRUNSWICK NJ
08901
US

IV. Provider business mailing address

66 WEST GILBERT ST
RED BANK NJ
07701
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-7985
  • Fax: 732-235-8124
Mailing address:
  • Phone: 732-212-0051
  • Fax: 732-212-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMA30620
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMA30620
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: