Individual
CARMEN DELIA MERCADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4437 EXPRESS DR N, RONKONKOMA, NY 11779-5520
(631) 352-7434
Mailing address
4437 EXPRESS DR N, RONKONKOMA, NY 11779-5520
(631) 352-7434
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
192205
NY
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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