Provider Demographics
NPI:1861455560
Name:MERCY MEDICAL ASSOCIATES OF MAYS LANDING PA
Entity Type:Organization
Organization Name:MERCY MEDICAL ASSOCIATES OF MAYS LANDING PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:LURAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-625-7116
Mailing Address - Street 1:1161 ROUTE 50
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2158
Mailing Address - Country:US
Mailing Address - Phone:609-625-7116
Mailing Address - Fax:609-625-3275
Practice Address - Street 1:1161 ROUTE 50
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2158
Practice Address - Country:US
Practice Address - Phone:609-625-7116
Practice Address - Fax:609-625-3275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03920300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
093475Medicare PIN