Provider Demographics
NPI:1184307498
Name:MRS./MS. MERCY MOTO
Entity type:Organization
Organization Name:MRS./MS. MERCY MOTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:973-721-9939
Mailing Address - Street 1:27 S AVE W
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016
Mailing Address - Country:US
Mailing Address - Phone:973-721-9939
Mailing Address - Fax:202-899-1228
Practice Address - Street 1:27 S AVE W
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016
Practice Address - Country:US
Practice Address - Phone:973-721-9939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJFS5684192OtherNJ