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Individual

MS. TRICIA POBLETE MENDOZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
333 BORTHWICK AVE STE 100, PORTSMOUTH, NH 03801-4198
(603) 436-5110
Mailing address
20 LADD STREET, SUITE 404, PORTSMOUTH, NH 03801
(603) 205-2953
(603) 433-6341

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
246874
NY
2084P0805X
Geriatric Psychiatry Physician
Primary
14388
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03061869
NY
01
14388
NH LICENSE
NH
05
3098096
NH
Enumeration date
01/16/2008
Last updated
02/12/2024
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