Provider Demographics
NPI:1124272000
Name:MERCADO, MA CRISTINA MARIANO (MD)
Entity type:Individual
Prefix:DR
First Name:MA CRISTINA
Middle Name:MARIANO
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MA CRISTINA
Other - Middle Name:TOMAS
Other - Last Name:MARIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:123 TOMAHAWK CT
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4105
Mailing Address - Country:US
Mailing Address - Phone:908-359-7762
Mailing Address - Fax:908-837-9590
Practice Address - Street 1:505 E ROMIE LN STE K
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4031
Practice Address - Country:US
Practice Address - Phone:831-422-9066
Practice Address - Fax:831-422-4312
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08327500208000000X
NY251118208000000X
CAA106427208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics