| Mercado Roman Psychology Group Psc | |
|
Carr 119 Km 5.5 Interior, Bo. Puente Camuy PR 00627-0062 | |
| (787) 644-0743 | |
| Not Available |
| Full Name | Mercado Roman Psychology Group Psc |
|---|---|
| Speciality | Psychologist |
| Location | Carr 119 Km 5.5 Interior, Bo. Puente, Camuy, Puerto Rico |
| Authorized Official Name and Position | Mailene Marie Roman Tejera (PRESIDENT) |
| Authorized Official Contact | 7876440743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercado Roman Psychology Group Psc 162 Calle Helio Arecibo PR 00612-8866 Ph: (787) 644-0743 | Mercado Roman Psychology Group Psc Carr 119 Km 5.5 Interior, Bo. Puente Camuy PR 00627-0062 Ph: (787) 644-0743 |
| NPI Number | 1093415390 |
|---|---|
| Provider Enumeration Date | 03/06/2023 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/03/2023 |
| Medicare PECOS PAC ID | 5597122598 |
|---|---|
| Medicare Enrollment ID | O20230607000439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093415390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Mailene Marie Roman Tejera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356086482 PECOS PAC ID: 6406213404 Enrollment ID: I20230607000470 |
| Provider Name | Brian Mercado Ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700514221 PECOS PAC ID: 3274997291 Enrollment ID: I20230910000009 |
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