| Susan J Mendelsohn Pa | |
|
1919 Ne 45th St Ste 218 Fort Lauderdale FL 33308-5136 | |
| (954) 294-7036 | |
| (954) 652-1483 |
| Full Name | Susan J Mendelsohn Pa |
|---|---|
| Speciality | Psychologist |
| Location | 1919 Ne 45th St Ste 218, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Susan J Mendelsohn (PRESIDENT) |
| Authorized Official Contact | 9542947036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan J Mendelsohn Pa 204 Washington Avenue Lauderdale By The Sea FL 33308-3622 Ph: (954) 294-7036 | Susan J Mendelsohn Pa 1919 Ne 45th St Ste 218 Fort Lauderdale FL 33308-5136 Ph: (954) 294-7036 |
| NPI Number | 1376016501 |
|---|---|
| Provider Enumeration Date | 01/10/2019 |
| Last Update Date | 08/11/2023 |
| Certification Date | 08/11/2023 |
| Medicare PECOS PAC ID | 5991031973 |
|---|---|
| Medicare Enrollment ID | O20190729003248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376016501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan J Mendelsohn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669531596 PECOS PAC ID: 2062748049 Enrollment ID: I20190729003400 |
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