Healthcare Provider Details

I. General information

NPI: 1508416892
Provider Name (Legal Business Name): MERCER PERINATAL CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CAPITAL WAY
PENNINGTON NJ
08534-2520
US

IV. Provider business mailing address

1 CAPITAL WAY
PENNINGTON NJ
08534-2520
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-4575
  • Fax: 215-481-4843
Mailing address:
  • Phone: 215-481-4575
  • Fax: 215-481-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD A LATTA
Title or Position: PRESIDENT
Credential: MD
Phone: 215-481-4575