Provider Demographics
NPI:1275606030
Name:MERCADO, RAY (DO)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:
Last Name:MERCADO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BROOK ST STE 105
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5149
Mailing Address - Country:US
Mailing Address - Phone:631-459-1276
Mailing Address - Fax:
Practice Address - Street 1:111 BROOK ST STE 105
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5149
Practice Address - Country:US
Practice Address - Phone:631-459-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201502188208D00000X
NY201303207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology