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General NPI Number Information
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NPI Number | 1265464309
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Entity Type | Organization
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Legal Business Name | MERCER RENAL ASSOCIATES PA
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 1345 KUSER RD SUITE 2
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City | HAMILTON
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-585-1344
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Fax | 609-585-1355
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Provider Business Mailing Address
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Address Line | PO BOX 8422
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City | TRENTON
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State | NJ
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Zip | 08650
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Country | US
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Telephone | 609-585-1344
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Fax | 609-585-1355
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Authorized Official
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Title or Position | PHYSICIAN
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Name | AFSHIN HANNANI
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Credential | MD
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Telephone | 609-585-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MA05962800
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License Number State | NJ
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