Provider Demographics
NPI:1568281715
Name:MERCADO, DALILAH ARIEL (PEER SPECIALIST)
Entity type:Individual
Prefix:PROF
First Name:DALILAH
Middle Name:ARIEL
Last Name:MERCADO
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 JOHNSON AVE APT 1P
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4936
Mailing Address - Country:US
Mailing Address - Phone:347-483-9945
Mailing Address - Fax:
Practice Address - Street 1:3402 CLARENDON RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5004
Practice Address - Country:US
Practice Address - Phone:718-473-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-05
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist