| Doctor Name: | JAIME LYNNE MENDOLIA |
| NPI Number: | 1649580598 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA054350 |
| Business Practice Address: | 360 W Ruddle St Coaldale, PA - 182181027 |
| Business Phone Number: | 5706452131 |
| Business Fax Number: | |
| Mailing Address: | 215 S 2nd St, LEHIGHTON |
| State: | PA |
| Postal Code: | 182352105 |
| Phone Number: | 5709826694 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2010 |
| NPI Last Update Date: | 06/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA054350 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |