MEDICARE: DR. ANTHONY THOMAS MERCURI JR. 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	213E00000X	Podiatrist	SC001586L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	801213	OTHER	PA	FIRST PRIORITY HEALTH
2	0828220001	OTHER		RRMC DUR MED EQUIP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174537591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY THOMAS MERCURI JR. DPM

Provider Business Mailing Address
First Line	:	PO BOX 186
Second Line	:
City	:	DUNMORE
State	:	PA
Zip	:	18512-0186
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/31/2012

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