MEDICARE: ENDOCRINOLOGY SPECIALISTS AT MERCER LLC

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1265968580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDOCRINOLOGY SPECIALISTS AT MERCER LLC

Provider Business Mailing Address
First Line	:	1542 KUSER RD
Second Line	:	SUITE B3
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 KUSER RD
Second Line	:	SUITE B3
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3829
Country	:	US
Telephone Number	:	609-298-1844
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YAN WU
Credential	:
Telephone Number	:	609-298-1844

Provider Enumeration Date	:	05/05/2017
Last Update Date	:	05/05/2017

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