Provider Demographics
NPI:1366779878
Name:MERCIER, GEORGESMARIE (REGISTER NURSE)
Entity type:Individual
Prefix:MRS
First Name:GEORGESMARIE
Middle Name:
Last Name:MERCIER
Suffix:
Gender:F
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 COUNTISBURY AVE
Mailing Address - Street 2:NONE
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1748
Mailing Address - Country:US
Mailing Address - Phone:516-285-9101
Mailing Address - Fax:
Practice Address - Street 1:56 COUNTISBURY AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1748
Practice Address - Country:US
Practice Address - Phone:516-285-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4674301163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse