MEDICARE: A T MERCURI DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	SC001586L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	801213	OTHER	PA	FIRST PRIORITY HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114102829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A T MERCURI DPM

Provider Business Mailing Address
First Line	:	1416 MONROE AVE
Second Line	:	SUITE 205
City	:	DUNMORE
State	:	PA
Zip	:	18509-2477
Country	:	US
Telephone Number	:	570-344-8686
Fax Number	:	570-344-2841

Provider Business Practice Location Address
First Line	:	1416 MONROE AVE
Second Line	:	SUITE 205
City	:	DUNMORE
State	:	PA
Zip	:	18509-2477
Country	:	US
Telephone Number	:	570-344-8686
Fax Number	:	570-344-2841

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTHONY T MERCURI JR.
Credential	:	D.P.M.
Telephone Number	:	570-344-8686

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	09/17/2012

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Directions to “A T MERCURI DPM ” Practice Location

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