Provider Demographics
NPI:1447387162
Name:MENDELSON, ALLISON (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 PARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1853
Mailing Address - Country:US
Mailing Address - Phone:860-269-3228
Mailing Address - Fax:860-269-3229
Practice Address - Street 1:74 PARK RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1853
Practice Address - Country:US
Practice Address - Phone:860-269-3228
Practice Address - Fax:860-269-3229
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1898111N00000X
CT1740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA351175OtherHARVARD PILGRIM
MA1613545Medicaid
MA771717OtherGIC INDEMNITY
MA771717OtherTUFTS HEALTH
263444980Other1447387162
MA5283290OtherAETNA INDEMNITY
MAY36408OtherBCBS