Provider Demographics
NPI:1124212139
Name:MENDELSON, SHARI (SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 NORTH AVE
Mailing Address - Street 2:APT. 12 G
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9020 WALL ST
Practice Address - Street 2:HUDSONVIEW CARE CENTER
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6011
Practice Address - Country:US
Practice Address - Phone:201-861-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-02
Last Update Date:2007-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00363200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist