Healthcare Provider Details

I. General information

NPI: 1023735735
Provider Name (Legal Business Name): CENTERS MENTAL AND MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9528 LINCOLN HWY STE 1
BEDFORD PA
15522-3764
US

IV. Provider business mailing address

9528 LINCOLN HWY STE 1
BEDFORD PA
15522-3764
US

V. Phone/Fax

Practice location:
  • Phone: 814-310-5409
  • Fax: 814-310-5410
Mailing address:
  • Phone: 814-310-5409
  • Fax: 814-310-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC MERMELSTEIN
Title or Position: PRINCIPAL
Credential:
Phone: 917-902-2858