Provider Demographics
NPI:1871855932
Name:MENDOLA, KAREN ANN (MS)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:MENDOLA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:HANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, AA
Mailing Address - Street 1:94 GLENHURST RD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8422
Mailing Address - Country:US
Mailing Address - Phone:716-834-6933
Mailing Address - Fax:
Practice Address - Street 1:94 GLENHURST RD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8422
Practice Address - Country:US
Practice Address - Phone:716-834-6933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist