Provider Demographics
NPI:1831075811
Name:MERCADO GUEVARA, ISAAC (CRPA-P)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:MERCADO GUEVARA
Suffix:
Gender:M
Credentials:CRPA-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 BROADWAY BSMT
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2606
Mailing Address - Country:US
Mailing Address - Phone:347-242-8995
Mailing Address - Fax:
Practice Address - Street 1:623 BROADWAY BSMT
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2606
Practice Address - Country:US
Practice Address - Phone:347-242-8995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist