Individual
LISA M MENDONZA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2914 ELMWOOD AVE, KENMORE, NY 14217-1332
(716) 875-6700
(716) 875-6853
Mailing address
2914 ELMWOOD AVE, KENMORE, NY 14217-1332
(716) 875-6700
(716) 875-6853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
213141
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02109713
—
NY
Enumeration date
03/17/2006
Last updated
07/08/2007
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