Individual
GLENN J MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
255 LAFAYETTE AVE, SUFFERN, NY 10901-4817
(914) 493-8558
(914) 493-1488
Mailing address
95 GRASSLANDS RD, MUNGER PAVILION STE 120, VALHALLA, NY 10595-1652
(914) 493-8558
(914) 493-1488
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
148338
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00992998
—
NY
05
—
7414706
—
NJ
Enumeration date
09/30/2005
Last updated
09/26/2008
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