Provider Demographics
NPI:1881073815
Name:GEORGE-MERCURIUS, PAULETT URANIE
Entity type:Individual
Prefix:
First Name:PAULETT
Middle Name:URANIE
Last Name:GEORGE-MERCURIUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20933 111TH RD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1738
Mailing Address - Country:US
Mailing Address - Phone:917-414-8740
Mailing Address - Fax:
Practice Address - Street 1:20933 111TH RD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1738
Practice Address - Country:US
Practice Address - Phone:917-414-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317225-1251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care