Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist |
NPI | 1770010274 |
---|---|
Provider Name | Mr. Nicholas Roland Mercado |
First Address | New Hyde Park, NY 11040-1402 |
Second Address | New Hyde Park, NY 11040-1402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2017 |
Last Update Date | 09/05/2018 |