Provider Demographics
NPI:1760827109
Name:MENDELSON, JESSICA (DO)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 MAYFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3754
Mailing Address - Country:US
Mailing Address - Phone:440-312-4500
Mailing Address - Fax:
Practice Address - Street 1:6780 MAYFIELD ROAD
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:OH
Practice Address - Zip Code:44124-3754
Practice Address - Country:US
Practice Address - Phone:440-312-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012145208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist