Provider Demographics
NPI:1588820526
Name:MENDELSOHN ENDOCRINOLOGY, LLC
Entity Type:Organization
Organization Name:MENDELSOHN ENDOCRINOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MENDELSOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-502-6822
Mailing Address - Street 1:3515 HENRY HUDSON PKWY
Mailing Address - Street 2:#10E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1326
Mailing Address - Country:US
Mailing Address - Phone:917-502-6822
Mailing Address - Fax:
Practice Address - Street 1:134 E 73RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4208
Practice Address - Country:US
Practice Address - Phone:212-327-3007
Practice Address - Fax:212-327-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60238947261Q00000X
CT046809261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty