| Doctor Name: | JORLY ANNE SAMSON MENDEZ |
| NPI Number: | 1053694125 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 646635 |
| Business Practice Address: | 43 Somerset St Huntington Station, NY - 117468421 |
| Business Phone Number: | 6315208304 |
| Business Fax Number: | |
| Mailing Address: | 43 Somerset St, HUNTINGTON STATION |
| State: | NY |
| Postal Code: | 117468421 |
| Phone Number: | 6315208304 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2011 |
| NPI Last Update Date: | 10/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | 646635 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |