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Individual

DR. KENNETH A MERCER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD MPH

Contact information

Practice address
422 2ND AVE, NEW YORK, NY 10010-4002
(212) 684-6684
Mailing address
3901 INDEPENDENCE AVE, APT 1M, BRONX, NY 10463-1275
(718) 853-0953
(718) 853-0953

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
210817
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01893012
NY
Enumeration date
08/02/2005
Last updated
06/30/2016
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