Healthcare Provider Details

I. General information

NPI: 1194972372
Provider Name (Legal Business Name): MER ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615-625 MAIN AVE
PASSAIC NJ
07055
US

IV. Provider business mailing address

59 MILL ROAD EXT
WOODCLIFF LAKE NJ
07677-8122
US

V. Phone/Fax

Practice location:
  • Phone: 917-731-9930
  • Fax:
Mailing address:
  • Phone: 917-731-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. MIKHAIL LIPSKY
Title or Position: MANAGER
Credential:
Phone: 917-731-9930