Organization
MESIDOR CONSULTING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALESSA MESIDOR NP (OWNER)
(551) 275-5674
Entity
Organization
Contact information
Practice address
1400 WANTAGH AVE, WANTAGH, NY 11793-2257
(551) 275-5674
Mailing address
1400 WANTAGH AVE, WANTAGH, NY 11793-2257
(551) 275-5674
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06885978
—
NY
Enumeration date
01/31/2023
Last updated
01/31/2023
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