Provider Demographics
NPI:1831427426
Name:MENDELSON, GAD (MD)
Entity type:Individual
Prefix:
First Name:GAD
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 1:28A DENIA ST
Mailing Address - Street 2:POBOX 55490
Mailing Address - City:HAIFA
Mailing Address - State:HAIFA
Mailing Address - Zip Code:34980
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28A DENIA ST BOX 55490
Practice Address - Street 2:
Practice Address - City:HAIFA
Practice Address - State:HAIFA
Practice Address - Zip Code:34980
Practice Address - Country:IL
Practice Address - Phone:97250-626-1824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA236952314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility