Provider Demographics
NPI:1114092343
Name:MERCANTE, THOMAS WILLIAM (DC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:MERCANTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 HEMPSTEAD TPK
Mailing Address - Street 2:CENTRAL AVE
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003
Mailing Address - Country:US
Mailing Address - Phone:516-616-6669
Mailing Address - Fax:516-616-6683
Practice Address - Street 1:1115 CENTRAL AVE UNIT C
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-3072
Practice Address - Country:US
Practice Address - Phone:843-771-3487
Practice Address - Fax:843-832-4978
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3279111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX73132Medicare ID - Type Unspecified
U62327Medicare UPIN