Francisco Manuel Mercado Bolivar

Individual provider Active NPI Military Health Care Provider · East Moriches, NY

NPI 1174334353 · NPPES record last updated Jan 16, 2025

Key facts

NPI
1174334353
Entity type
Individual (NPI type 1)
Primary specialty
Military Health Care Provider 171000000X
Practice address
100 Moriches Island Rd
East Moriches, NY 11940-1315
Phone
(516) 369-2357
NPI assigned
Jan 16, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X Yes

Addresses

Primary practice location

100 Moriches Island Rd
East Moriches, NY 11940-1315

Mailing address

100 Moriches Island Rd
East Moriches, NY 11940-1315
Phone (516) 369-2357

Other providers in East Moriches, NY

All providers in East Moriches, NY · Military Health Care Provider in New York

Sources for this page

Verify at the official NPI Registry.