Provider Demographics
NPI:1245615442
Name:SANCHEZ MENDEZ, ESTEFANY
Entity type:Individual
Prefix:
First Name:ESTEFANY
Middle Name:
Last Name:SANCHEZ MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 MYRTLE AVENUE
Mailing Address - Street 2:WYCKOFF PROFESSIONAL AND MEDICAL SERVICES, PC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237
Mailing Address - Country:US
Mailing Address - Phone:718-907-4301
Mailing Address - Fax:718-919-1309
Practice Address - Street 1:374 STOCKHOLM STREET - FACULTY PRACTICE DEPT
Practice Address - Street 2:WYCKOFF PROFESSIONAL AND MEDICAL SERVICES, PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237
Practice Address - Country:US
Practice Address - Phone:718-963-7676
Practice Address - Fax:718-963-6667
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP97863208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWX0341Medicare PIN