Doctor Name: | ANGELICA MENDOZA |
NPI Number: | 1902158322 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | NJ41YS00748000 |
Business Practice Address: | 4 Railroad Ave Somerset, NJ - 088732724 |
Business Phone Number: | 7326493439 |
Business Fax Number: | |
Mailing Address: | 3391 Richmond Ave, STATEN ISLAND |
State: | NY |
Postal Code: | 103122025 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/09/2012 |
NPI Last Update Date: | 12/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | NJ41YS00748000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |