Healthcare Provider Details

I. General information

NPI: 1841904653
Provider Name (Legal Business Name): PATRICIA ESQUIVEL MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 01/09/2023
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2722 VICTORY BLVD APT 1A
STATEN ISLAND NY
10314-6644
US

IV. Provider business mailing address

2722 VICTORY BLVD APT 1A
STATEN ISLAND NY
10314-6644
US

V. Phone/Fax

Practice location:
  • Phone: 646-489-0268
  • Fax:
Mailing address:
  • Phone: 646-489-0268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: