Provider Demographics
NPI:1750963518
Name:MINGO, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:MINGO
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 1:189 DELAWARE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-2115
Mailing Address - Country:US
Mailing Address - Phone:716-247-0115
Mailing Address - Fax:
Practice Address - Street 1:742 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2202
Practice Address - Country:US
Practice Address - Phone:716-431-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator