Individual
ELIZABETH A MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 737-7770
(607) 271-3686
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
260167
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03322781
—
NY
05
—
102594525
—
PA
Enumeration date
02/22/2011
Last updated
06/16/2016
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