Provider Demographics
NPI:1427859966
Name:MERCURIUS, DANIELLE A
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:MERCURIUS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N 3RD AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1354
Mailing Address - Country:US
Mailing Address - Phone:929-421-5606
Mailing Address - Fax:
Practice Address - Street 1:33 N 3RD AVE APT 3L
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1354
Practice Address - Country:US
Practice Address - Phone:929-421-5606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY980892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse