Provider Demographics
NPI:1558572768
Name:MERCALDI, RICHARD (PTA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:MERCALDI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 HEMINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-9309
Mailing Address - Country:US
Mailing Address - Phone:863-944-1273
Mailing Address - Fax:
Practice Address - Street 1:4157 HEMINGWAY DR
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-9309
Practice Address - Country:US
Practice Address - Phone:863-944-1273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA10108225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant