Provider Demographics
NPI:1952485971
Name:MERCER BUCKS MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:MERCER BUCKS MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE MARIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-943-2000
Mailing Address - Street 1:1411 WOODBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1504
Mailing Address - Country:US
Mailing Address - Phone:215-943-2000
Mailing Address - Fax:215-943-4439
Practice Address - Street 1:1411 WOODBOURNE RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1504
Practice Address - Country:US
Practice Address - Phone:215-943-2000
Practice Address - Fax:215-943-4439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050625L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0163895001OtherIBC
PA000717962OtherHIGHMARK
PA034817Medicare ID - Type Unspecified