Provider Demographics
NPI:1558825075
Name:MENDOZA-BISWAS, SHERRYBEL LUDAN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRYBEL
Middle Name:LUDAN
Last Name:MENDOZA-BISWAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12229 MARNE LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1814
Mailing Address - Country:US
Mailing Address - Phone:202-674-9123
Mailing Address - Fax:
Practice Address - Street 1:7610 CARROLL AVE STE 400
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6321
Practice Address - Country:US
Practice Address - Phone:301-891-6141
Practice Address - Fax:301-891-6841
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR213140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily