| Mendoza Chiropractic Office Pc | |
|
717 Front St, Hempstead, NY 11550-4534 | |
| (516) 565-3534 | |
| (516) 565-2745 |
| Full Name | Mendoza Chiropractic Office Pc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 717 Front St, Hempstead, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528125515 | NPI | - | NPPES |
| X007741 | Other | NY | NYS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | X007741 (New York) | Primary |
| Provider Name | Manuel A Mendoza |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871650853 PECOS PAC ID: 2769551761 Enrollment ID: I20080516000386 |
| Provider Name | Shane Ronald Raymond |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699300533 PECOS PAC ID: 8325492861 Enrollment ID: I20231002002697 |
| Mailing Address | Practice Location Address |
|---|---|
| Mendoza Chiropractic Office Pc 717 Front St, Hempstead, NY 11550-4534 Ph: (516) 565-3534 | Mendoza Chiropractic Office Pc 717 Front St, Hempstead, NY 11550-4534 Ph: (516) 565-3534 |
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