Provider Demographics
NPI:1548068653
Name:MERCY ASSOCIATES LLC
Entity type:Organization
Organization Name:MERCY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:OTIENO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:551-580-1893
Mailing Address - Street 1:517 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:517 WOOD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-2347
Practice Address - Country:US
Practice Address - Phone:551-580-1893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty