Organization
FREDERIC A MENDELSOHN NEURODIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERIC A MENDELSOHN MD (OWNER/MD)
(631) 987-3705
Entity
Organization
Contact information
Practice address
30 SEASIDE DR, PORT JEFFERSON, NY 11777-1132
(631) 987-3705
Mailing address
30 SEASIDE DR, PORT JEFFERSON, NY 11777-1132
(631) 987-3705
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00655156
—
NY
Enumeration date
01/30/2019
Last updated
01/30/2019
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