Provider Demographics
NPI:1598068645
Name:MERCADO, CECILIA (LICENSED MASSAGE THE)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:LICENSED MASSAGE THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 EAGLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049
Mailing Address - Country:US
Mailing Address - Phone:610-252-8900
Mailing Address - Fax:610-252-8900
Practice Address - Street 1:15 CENTRE SQUARE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042
Practice Address - Country:US
Practice Address - Phone:610-252-8900
Practice Address - Fax:610-252-8900
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014268225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist