Provider Demographics
NPI:1497311344
Name:JUAREZ MENDEZ, ERIK EDGARDO
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:EDGARDO
Last Name:JUAREZ MENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 DEWEY RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1414
Mailing Address - Country:US
Mailing Address - Phone:267-253-6588
Mailing Address - Fax:
Practice Address - Street 1:512 W HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1505
Practice Address - Country:US
Practice Address - Phone:484-221-9535
Practice Address - Fax:484-221-9440
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health