Provider Demographics
NPI:1548244528
Name:MENDEZ, DANIEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:MENDEZ
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 1:7449 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-3973
Mailing Address - Country:US
Mailing Address - Phone:315-451-5400
Mailing Address - Fax:
Practice Address - Street 1:7449 MORGAN RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-3973
Practice Address - Country:US
Practice Address - Phone:315-451-5400
Practice Address - Fax:315-451-5422
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07103300208100000X
NY2171681208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD07836100OtherCDS
BM6756184OtherDEA
70Z601Medicare ID - Type Unspecified
NJD07836100OtherCDS