Provider Demographics
NPI:1689800120
Name:MPC
Entity Type:Organization
Organization Name:MPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:YUET
Authorized Official - Middle Name:
Authorized Official - Last Name:LERCARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-672-6477
Mailing Address - Street 1:600 EAST 125 ST.
Mailing Address - Street 2:WARDS ISLAND COMPLEX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-6000
Mailing Address - Country:US
Mailing Address - Phone:646-672-6477
Mailing Address - Fax:646-672-6484
Practice Address - Street 1:600 EAST 125 ST.
Practice Address - Street 2:WARDS ISLAND COMPLEX
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-6000
Practice Address - Country:US
Practice Address - Phone:646-672-6477
Practice Address - Fax:646-672-6484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036280283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital