Provider Demographics
NPI:1841696481
Name:PENSOTES, JULIE ANNE MENDEZ
Entity type:Individual
Prefix:
First Name:JULIE ANNE
Middle Name:MENDEZ
Last Name:PENSOTES
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 1:4951 CHAMBERS STREET
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1209
Mailing Address - Country:US
Mailing Address - Phone:212-221-1544
Mailing Address - Fax:
Practice Address - Street 1:4951 CHAMBERS STREET
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1209
Practice Address - Country:US
Practice Address - Phone:212-221-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0187361225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist