Provider Demographics
NPI:1689067431
Name:MERCADO, JANET (LPN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:MELINA
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:20 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-5504
Mailing Address - Country:US
Mailing Address - Phone:914-338-5055
Mailing Address - Fax:
Practice Address - Street 1:20 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-5504
Practice Address - Country:US
Practice Address - Phone:914-338-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319740-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse