Individual
CORINNA LUISE MENDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PA.C.
Contact information
Practice address
2500 NESCONSET HWY, BLDG 21C, STONY BROOK, NY 11790-2555
(631) 246-8289
(631) 246-8294
Mailing address
2500 NESCONSET HIGHWAY, BLDG 21C, STONY BROOK, NY 11790
(631) 246-8289
(631) 246-8294
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012299
NY
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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