Healthcare Provider Details

I. General information

NPI: 1649539644
Provider Name (Legal Business Name): DAUGHTERS OF MARY MOTHER OF MERCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 S BRADDOCK AVE
SWISSVALE PA
15218-2124
US

IV. Provider business mailing address

2021 S BRADDOCK AVE
SWISSVALE PA
15218-2124
US

V. Phone/Fax

Practice location:
  • Phone: 347-278-5287
  • Fax:
Mailing address:
  • Phone: 347-278-5287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNONE
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StatePA

VIII. Authorized Official

Name: JOSEPHINE OBIAGELI EMEH
Title or Position: MASTERS DEGREE
Credential: M.D.,
Phone: 347-278-5287