Provider Demographics
NPI:1043300189
Name:MERE, EAST A (MD)
Entity Type:Individual
Prefix:DR
First Name:EAST
Middle Name:A
Last Name:MERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARQUE MONTEBELLO F-22 ST.2
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-760-0019
Mailing Address - Fax:787-766-0534
Practice Address - Street 1:445 CALLE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2639
Practice Address - Country:US
Practice Address - Phone:787-767-2131
Practice Address - Fax:787-766-0534
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11422207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0089585Medicare ID - Type Unspecified
PRH35843Medicare UPIN