Provider Demographics
NPI:1710994827
Name:MENDELL, MARK F (NP)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:MENDELL
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:PHYSICIAN CONTRACTING, SUITE 2502
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-7362
Mailing Address - Fax:302-623-7374
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:MAP 2, SUITE 3301
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2072
Practice Address - Country:US
Practice Address - Phone:302-623-4370
Practice Address - Fax:302-623-4375
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-03-02
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Provider Licenses
StateLicense IDTaxonomies
DELB-0000156363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE019781C63Medicare PIN
P53842Medicare UPIN