Provider Demographics
NPI:1366471203
Name:MERCER MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:MERCER MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-599-1004
Mailing Address - Street 1:40 FULD STREET
Mailing Address - Street 2:SUITE 401
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638
Mailing Address - Country:US
Mailing Address - Phone:609-599-1004
Mailing Address - Fax:609-599-3611
Practice Address - Street 1:40 FULD STREET
Practice Address - Street 2:SUITE 401
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638
Practice Address - Country:US
Practice Address - Phone:609-599-1004
Practice Address - Fax:609-599-3611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2782308Medicaid
NJ2782308Medicaid