| Doctor Name: | MS. MELISSA MERCADO |
| NPI Number: | 1225199193 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 25MP00170200 |
| Business Practice Address: | 701 Ostrum St Suite 603 Fountain Hill, PA - 180151155 |
| Business Phone Number: | 6109543990 |
| Business Fax Number: | 6108682915 |
| Mailing Address: | 701 Ostrum St, Suite 603 FOUNTAIN HILL |
| State: | PA |
| Postal Code: | 180151155 |
| Phone Number: | 6109543990 |
| Fax Number: | 6108682915 |
| NPI Enumeration Date: | 12/13/2006 |
| NPI Last Update Date: | 08/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 25MP00170200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |