Provider Demographics
NPI:1558434803
Name:MENDES, JOHN F (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:MENDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:440 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-2302
Mailing Address - Country:US
Mailing Address - Phone:201-358-0707
Mailing Address - Fax:201-358-9777
Practice Address - Street 1:1 BAY AVE
Practice Address - Street 2:2NORTH
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4837
Practice Address - Country:US
Practice Address - Phone:973-680-7831
Practice Address - Fax:973-680-7839
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA40573207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D07094Medicare UPIN
NJME077210B12Medicare PIN
NJME077210B12Medicare PIN