| NPI | 1528673050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK MERCER Credentialing Specialist 718-877-6388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-09-11 |