Individual
FREDERIC A MENDELSOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 HAWKINS AVE, SUITE 7, RONKONKOMA, NY 11779-2366
(631) 737-0055
(631) 737-0076
Mailing address
PO BOX 491, PORT JEFFERSON STATION, NY 11776-0491
(631) 737-0055
(631) 737-0076
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
112676
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00655156
—
NY
Enumeration date
09/20/2006
Last updated
07/21/2010
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