Individual
JORLY ANNE SAMSON MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
43 SOMERSET ST, HUNTINGTON STATION, NY 11746-8421
(631) 520-8304
Mailing address
43 SOMERSET ST, HUNTINGTON STATION, NY 11746-8421
(631) 520-8304
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
646635
NY
163WH0200X
Home Health Registered Nurse
Primary
646635
NY
163WP0200X
Pediatric Registered Nurse
646635
NY
Other
Enumeration date
09/24/2011
Last updated
10/03/2011
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