Provider Demographics
NPI:1720092075
Name:MERCY PSYCHIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:MERCY PSYCHIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEKRET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-524-1552
Mailing Address - Street 1:1503 LANSDOWNE AVE
Mailing Address - Street 2:SUITE 3005
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1330
Mailing Address - Country:US
Mailing Address - Phone:610-524-1552
Mailing Address - Fax:610-524-6039
Practice Address - Street 1:1503 LANSDOWNE AVE
Practice Address - Street 2:SUITE 3005
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1330
Practice Address - Country:US
Practice Address - Phone:610-524-1552
Practice Address - Fax:610-524-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACG9758OtherRAILROAD MEDICARE
PA0012761760004Medicaid
PA0555445000OtherPERSONAL CHOICE
PA718501Medicare ID - Type Unspecified