Provider Demographics
NPI:1396500443
Name:MENDELSOHN, ROBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:MENDELSOHN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 HARBOR HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2326
Mailing Address - Country:US
Mailing Address - Phone:516-384-2484
Mailing Address - Fax:
Practice Address - Street 1:213 HARBOR HILL RD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-2326
Practice Address - Country:US
Practice Address - Phone:516-384-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3719103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical