| Organization Name: | MOUNT VERNON MEDICAL PRACTICE |
| NPI Number: | 1033512843 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARMEN MENDEZ (FNP-C) |
| Mailing Address: | 175 Memorial Hwy Suite 1-4 New Rochelle |
| State: | NY US |
| Postal Code: | 108015635 |
| Phone Number: | 9146335700 |
| Fax Number: | 9146330446 |
| NPI Enumeration Date: | 10/07/2014 |
| NPI Last Update Date: | 10/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | F338574-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |