Provider Demographics
NPI:1871972463
Name:RAY MERCADO DO PC
Entity type:Organization
Organization Name:RAY MERCADO DO PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-281-8000
Mailing Address - Street 1:1931 WILLIAMSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1632
Mailing Address - Country:US
Mailing Address - Phone:347-281-8000
Mailing Address - Fax:347-281-8186
Practice Address - Street 1:1931 WILLIAMSBRIDGE RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1632
Practice Address - Country:US
Practice Address - Phone:347-281-8000
Practice Address - Fax:347-281-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201303207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty