Healthcare Provider Details

I. General information

NPI: 1679767602
Provider Name (Legal Business Name): HARMON PAUL MERCER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2007
Last Update Date: 09/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

102 BEDFORD RD
HEMPSTEAD NY
11550-7502
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-3663
  • Fax:
Mailing address:
  • Phone: 516-214-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number408844-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number408844-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: