Healthcare Provider Details

I. General information

NPI: 1316879323
Provider Name (Legal Business Name): STEFANIA MERCURIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WILNER RD
SOMERS NY
10589-3000
US

IV. Provider business mailing address

11 WILNER RD
SOMERS NY
10589-3000
US

V. Phone/Fax

Practice location:
  • Phone: 914-746-0832
  • Fax:
Mailing address:
  • Phone: 914-746-0832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: