Healthcare Provider Details

I. General information

NPI: 1619245610
Provider Name (Legal Business Name): MERCY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N. VILLAGE AVENUE
ROCKVILLE CENTRE NY
11570
US

IV. Provider business mailing address

P.O. BOX 798
ROCKVILLE CENTRE NY
11571
US

V. Phone/Fax

Practice location:
  • Phone: 516-705-1613
  • Fax: 516-705-3575
Mailing address:
  • Phone: 516-705-1403
  • Fax: 516-705-3575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2909000H
License Number StateNY

VIII. Authorized Official

Name: ALAN GUERCI
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 516-562-6798