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General NPI Number Information
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NPI Number | 1154187003
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Entity Type | Individual
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Provider Name | ERIC DEVANEY MERCADANTE LMSW
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Gender | Male
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 6 CHELSEA PL STE 103
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3236
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Country | US
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Telephone | 844-253-4229
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Fax |
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Provider Business Mailing Address
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Address Line | 60 FIELDSTONE DR
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City | GANSEVOORT
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State | NY
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Zip | 12831-1714
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Country | US
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Telephone | 518-469-1979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 121459
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License Number State | NY
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