Provider Demographics
NPI:1942782958
Name:MERCER MEDICAL & WELLNESS LLC
Entity Type:Organization
Organization Name:MERCER MEDICAL & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAURENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-587-0119
Mailing Address - Street 1:PO BOX 3393
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-0393
Mailing Address - Country:US
Mailing Address - Phone:609-587-0119
Mailing Address - Fax:609-587-3009
Practice Address - Street 1:1601 WHITEHORSE MERCERVILLE RD STE 4
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3836
Practice Address - Country:US
Practice Address - Phone:609-587-0119
Practice Address - Fax:609-587-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty