Provider Demographics
NPI:1194390039
Name:MENDELSON, RONI RACHEL (MD)
Entity Type:Individual
Prefix:MRS
First Name:RONI RACHEL
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 RESERVOIR RD, NW
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-428-5414
Mailing Address - Fax:202-687-8935
Practice Address - Street 1:3800 RESERVOIR RD, NW
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-243-3400
Practice Address - Fax:202-687-8935
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2023-02-13
Deactivation Date:2022-11-14
Deactivation Code:
Reactivation Date:2023-02-13
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0116035335390200000X
DCMTL200001326390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program