Provider Demographics
NPI:1922261874
Name:MERCER, LAUREN C (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:MERCER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WASHINGTON AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3271
Mailing Address - Country:US
Mailing Address - Phone:203-288-0414
Mailing Address - Fax:203-288-3655
Practice Address - Street 1:60 WASHINGTON AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3271
Practice Address - Country:US
Practice Address - Phone:203-288-0414
Practice Address - Fax:203-288-3655
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT524992084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry