Provider Demographics
NPI:1275561342
Name:MENDEL, EHUD (MD)
Entity Type:Individual
Prefix:
First Name:EHUD
Middle Name:
Last Name:MENDEL
Suffix:
Gender:M
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:PO BOX 208082
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8082
Mailing Address - Country:US
Mailing Address - Phone:203-737-2936
Mailing Address - Fax:203-785-3698
Practice Address - Street 1:333 CEDAR STREET
Practice Address - Street 2:TOMPKINS 4
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-737-7000
Practice Address - Fax:032-737-1486
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT69654207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2673307Medicaid
OH2673307Medicaid
OHME4189071Medicare PIN