Provider Demographics
NPI:1144482209
Name:MERCADO, HELEN VELASQUEZ (PT)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:VELASQUEZ
Last Name:MERCADO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LITTLE BRITAIN RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-567-7789
Mailing Address - Fax:845-567-1411
Practice Address - Street 1:10 LITTLE BRITAIN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-567-7789
Practice Address - Fax:845-567-1411
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQM5121Medicare PIN