Provider Demographics
NPI:1851320634
Name:MERCURO, T J (MD)
Entity Type:Individual
Prefix:DR
First Name:T
Middle Name:J
Last Name:MERCURO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:T
Other - Middle Name:JOHN
Other - Last Name:MERCURO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:800 BUNN DR.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1968
Mailing Address - Country:US
Mailing Address - Phone:609-921-2800
Mailing Address - Fax:609-921-3499
Practice Address - Street 1:800 BUNN DR.
Practice Address - Street 2:SUITE 101
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1968
Practice Address - Country:US
Practice Address - Phone:609-921-2800
Practice Address - Fax:609-921-3499
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04835700207RC0000X, 207RI0011X, 207UN0901X
PAMD040718E207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
223258770OtherMAGNA CARE
NJ7634102Medicaid
561376OtherAMERIHEALTH ADMIN PPO
0K1810OtherHEALTHNET
223258770OtherAARP HEALTH INSURANCE
PA561376OtherBLUE SHIELD PA
223258770OtherGREAT WEST
NJ223258770OtherHORZON BCBS OF NJ
060022662OtherRAILROAD MEDICARE
223258770OtherBEECHSTREET
223258770OtherDEVON
P420654OtherOXFORD HEALTH PLANS
0382725000OtherAMERIHEALTH HMO
223258770OtherCIGNA
460972OtherAETNA US HEALTHCARE
PA0382725000OtherKEYSTONE HEALTH PLANS
223258770OtherGHI
0K1810OtherHEALTHNET
PA561376OtherBLUE SHIELD PA
223258770OtherCIGNA