Individual
DR. ERNESTO A MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40-45 78TH STREET, ELMHURST, NY 11373
(718) 397-9058
(718) 446-1298
Mailing address
1 BROOKDALE PLAZA, PHYSICIAN ENTERPRISE, BROOKLYN, NY 11212
(718) 240-7143
(718) 240-5808
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
152994-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00935126
—
NY
Enumeration date
08/09/2006
Last updated
05/19/2020
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