Healthcare Provider Details

I. General information

NPI: 1811087687
Provider Name (Legal Business Name): MERCY OB/GYN , PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 233RD ST 5TH FLOOR
BRONX NY
10466-2604
US

IV. Provider business mailing address

600 E 233RD ST 5TH FLOOR
BRONX NY
10466-2604
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-9647
  • Fax: 718-920-9095
Mailing address:
  • Phone: 718-920-9647
  • Fax: 718-920-9095

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: KEVIN D REILLY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-920-9647