Provider Demographics
NPI:1902018872
Name:MENDEZ, HERMANN A (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMANN
Middle Name:A
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX49
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-2271
Mailing Address - Fax:718-270-4137
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:BOX49
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-2271
Practice Address - Fax:718-270-4137
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1772592080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01845183Medicaid
NY01845183Medicaid
NYOB3401Medicare ID - Type Unspecified