| Michael W. Mendelson, M.d., P.c. | |
|
5360 Nesconset Hwy Ste B Port Jefferson Station NY 11776-2018 | |
| (631) 331-3200 | |
| (631) 331-3694 |
| Full Name | Michael W. Mendelson, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5360 Nesconset Hwy Ste B, Port Jefferson Station, New York |
| Authorized Official Name and Position | Michael W Mendelson (PRESIDENT) |
| Authorized Official Contact | 6313313200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael W. Mendelson, M.d., P.c. 5360 Nesconset Hwy Ste B Port Jefferson Station NY 11776-2018 Ph: (631) 331-3200 | Michael W. Mendelson, M.d., P.c. 5360 Nesconset Hwy Ste B Port Jefferson Station NY 11776-2018 Ph: (631) 331-3200 |
| NPI Number | 1023318292 |
|---|---|
| Provider Enumeration Date | 10/22/2010 |
| Last Update Date | 05/24/2021 |
| Medicare PECOS PAC ID | 4688858947 |
|---|---|
| Medicare Enrollment ID | O20110411000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023318292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 110115 (New York) | Primary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | 110115 (New York) | Secondary |
| Provider Name | Michael W Mendelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043323835 PECOS PAC ID: 9830214691 Enrollment ID: I20100916000622 |
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