Provider Demographics
NPI:1548967789
Name:BERCY, MYRA JEAN
Entity type:Individual
Prefix:
First Name:MYRA
Middle Name:JEAN
Last Name:BERCY
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 1:7820 UNITY DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2027
Mailing Address - Country:US
Mailing Address - Phone:504-228-9972
Mailing Address - Fax:
Practice Address - Street 1:3303 TULANE AVE BLDG 3
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7186
Practice Address - Country:US
Practice Address - Phone:504-302-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator