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General NPI Number Information
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NPI Number | 1508074261
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Entity Type | Organization
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Legal Business Name | OUR LADY OF MERCY MEDICAL CENTER
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4401 BRONX BLVD
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City | BRONX
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State | NY
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Zip | 10470-1407
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Country | US
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Telephone | 717-304-7000
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Fax | 718-304-7065
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Provider Business Mailing Address
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Address Line | 4401 BRONX BLVD
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City | BRONX
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State | NY
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Zip | 10470-1407
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Country | US
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Telephone | 717-304-7000
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Fax | 718-304-7065
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Authorized Official
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Title or Position | CHIF PSYCHIATRIST, AMBULATORY PSYCH
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Name | DR. AHMED HAKKI
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Credential | MD
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Telephone | 717-304-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 101796
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License Number State | NY
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