Provider Demographics
NPI:1831281518
Name:MERCER, DENISE (OD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 W RIDGE PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1778
Mailing Address - Country:US
Mailing Address - Phone:610-489-8786
Mailing Address - Fax:610-489-6544
Practice Address - Street 1:168 W RIDGE PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1778
Practice Address - Country:US
Practice Address - Phone:610-489-8786
Practice Address - Fax:610-489-6544
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001167152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU63949Medicare UPIN
PA889209Q8VMedicare ID - Type Unspecified