Provider Demographics
NPI:1194796995
Name:DERMODY, MERICA GELLERMANN (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:MERICA
Middle Name:GELLERMANN
Last Name:DERMODY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1800
Mailing Address - Country:US
Mailing Address - Phone:800-631-5250
Mailing Address - Fax:
Practice Address - Street 1:69 1ST AVE
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1800
Practice Address - Country:US
Practice Address - Phone:800-631-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MJ00000800170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS