Basic Information
| Provider Information | |||||||||
| NPI: | 1952485971 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MERCER BUCKS MEDICAL ASSOCIATES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1411 WOODBOURNE RD | ||||||||
| Address2: | |||||||||
| City: | LEVITTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190571504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159432000 | ||||||||
| FaxNumber: | 2159434439 | ||||||||
| Practice Location | |||||||||
| Address1: | 1411 WOODBOURNE RD | ||||||||
| Address2: | |||||||||
| City: | LEVITTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190571504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159432000 | ||||||||
| FaxNumber: | 2159434439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 09/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | SAJJAD | ||||||||
| AuthorizedOfficialFirstName: | SYED | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2139432000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD050625L | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0163895001 | 01 | PA | IBC | OTHER | 000717962 | 01 | PA | HIGHMARK | OTHER |