MERCILA ROBERTY NPI 1790301745

NPI Information

  • NPI: 1790301745
  • Provider Name: MERCILA ROBERTY
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 11 6TH AVE
    BRENTWOOD, NY
    ZIP 11717
  • Phone: (631) 787-4815

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NPI Details

Mercila Roberty is a licensed practical nurse in Brentwood, NY. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Mercila Roberty NPI is 1790301745. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11 6TH AVE
BRENTWOOD, NY
ZIP 11717-122
Phone: (631) 787-4815

The enumeration date for this NPI number is 6/24/2020 and was last updated on 6/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse334716NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1334716MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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