Provider Demographics
NPI:1427840495
Name:MENDELSON, NECHAMA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:NECHAMA
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 RYDER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4307
Mailing Address - Country:US
Mailing Address - Phone:917-763-7596
Mailing Address - Fax:
Practice Address - Street 1:1630 RYDER ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4307
Practice Address - Country:US
Practice Address - Phone:917-763-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033473363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical