Provider Demographics
NPI:1265464309
Name:MERCER RENAL ASSOCIATES PA
Entity Type:Organization
Organization Name:MERCER RENAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AFSHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-585-1344
Mailing Address - Street 1:PO BOX 8422
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08650
Mailing Address - Country:US
Mailing Address - Phone:609-585-1344
Mailing Address - Fax:609-585-1355
Practice Address - Street 1:1345 KUSER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-585-1344
Practice Address - Fax:609-585-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05962800207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
097638Medicare ID - Type Unspecified
NJF60625Medicare UPIN