Individual
JESSICA EVA MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2363 GRAND AVE, APT 10C3, BALDWIN, NY 11510-3102
(516) 717-8275
Mailing address
2363 GRAND AVE, APT 10C3, BALDWIN, NY 11510-3102
(516) 717-8275
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/05/2012
Last updated
03/12/2013
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