Individual
DR. KIM KEZIAH MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
101 HOSPITAL RD, BROOKHAVEN MEMORIAL HOSPITAL, PATCHOGUE, NY 11772-4870
(631) 687-4124
Mailing address
3 COOKS RD, EAST PATCHOGUE, NY 11772-5606
(631) 687-4124
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300689-1
NY
Other
Enumeration date
02/14/2007
Last updated
07/08/2007
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