Provider Demographics
NPI:1225498512
Name:MERCADO, MARIA LORELIE HALAGAO (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARIA LORELIE
Middle Name:HALAGAO
Last Name:MERCADO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8854 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5804
Mailing Address - Country:US
Mailing Address - Phone:917-403-7873
Mailing Address - Fax:
Practice Address - Street 1:8854 16TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5804
Practice Address - Country:US
Practice Address - Phone:917-403-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013003-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist