Provider Demographics
NPI:1659574408
Name:BAY EAST ENDOCRINOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:BAY EAST ENDOCRINOLOGY ASSOCIATES PA
Other - Org Name:MERSEY ENDOCRINOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:MERSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-828-7417
Mailing Address - Street 1:8579 COMMERCE DR
Mailing Address - Street 2:SUITE 108A
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7491
Mailing Address - Country:US
Mailing Address - Phone:410-828-7417
Mailing Address - Fax:410-828-5052
Practice Address - Street 1:8579 COMMERCE DR
Practice Address - Street 2:SUITE 108A
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7491
Practice Address - Country:US
Practice Address - Phone:410-828-7417
Practice Address - Fax:410-828-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19323174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK863Medicare ID - Type Unspecified