Individual
ALI MENDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(800) 879-2467
Mailing address
3401 CIVIC CENTER BLVD STE M975, PHILADELPHIA, PA 19104-4319
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
MD468483
PA
208000000X
Pediatrics Physician
233946
NY
208M00000X
Hospitalist Physician
MD468483
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092370
GHI HMO PROVIDER ID#
—
05
—
02727509
—
NY
01
—
0604050000013
FIDELISCARE PROVIDER ID#
—
01
—
10101978-U104
CDPHP PROVIDER & GRP ID#
—
01
—
1093491
AETNA-HMO PROVIDER ID#
—
01
—
388179
MVP HEALTHPLAN PIN#
—
01
—
3C5202
HEALTHNET GRP ID#
—
01
—
634Z61
EMPIRE BCBS PROVIDER ID#
—
01
—
7187742
AETNA-PPO PROVIDER ID#
—
01
—
P3627881
OXFORD HEALTH PLAN PIN#
—
Enumeration date
09/23/2005
Last updated
12/18/2023
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