Provider Demographics
NPI:1477612950
Name:MENDELSON, JOEL (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2906
Mailing Address - Country:US
Mailing Address - Phone:908-233-4477
Mailing Address - Fax:
Practice Address - Street 1:1124 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2906
Practice Address - Country:US
Practice Address - Phone:908-233-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA047383002080P0208X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases