Provider Demographics
NPI:1770010274
Name:MERCADO, NICHOLAS ROLAND (MPH)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ROLAND
Last Name:MERCADO
Suffix:
Gender:M
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27005 76TH AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1402
Mailing Address - Country:US
Mailing Address - Phone:516-470-5840
Mailing Address - Fax:516-470-5845
Practice Address - Street 1:27005 76TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1402
Practice Address - Country:US
Practice Address - Phone:516-470-5840
Practice Address - Fax:516-470-5845
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174V00000XOther Service ProvidersClinical Ethicist
No174400000XOther Service ProvidersSpecialist