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General NPI Number Information
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NPI Number | 1396398335
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Entity Type | Organization
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Legal Business Name | E. MERCEDES CONSULTING AND SERVICES
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 526 BLOOMFIELD AVE STE 204
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City | CALDWELL
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State | NJ
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Zip | 07006
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Country | US
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Telephone | 973-841-4486
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Fax |
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Provider Business Mailing Address
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Address Line | 38 KNOLL TER
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-7306
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Country | US
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Telephone | 201-953-9074
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ENMANUEL MERCEDES
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Credential | PH.D.
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Telephone | 973-841-4486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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