Provider Demographics
NPI:1124340526
Name:PHILIP, MERCY W (RPH)
Entity type:Individual
Prefix:MRS
First Name:MERCY
Middle Name:W
Last Name:PHILIP
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 S FARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2514
Mailing Address - Country:US
Mailing Address - Phone:201-673-6733
Mailing Address - Fax:
Practice Address - Street 1:280 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3327
Practice Address - Country:US
Practice Address - Phone:845-639-8150
Practice Address - Fax:845-639-8156
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist