Most Relevant Information
Provider Data
| NPI Number: | 1003351172 |
| Provider Name: | CHARLEEN MENDES |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/28/2016 |
| Last Updated: | 12/28/2016 |
Provider Practice Location
11555 237TH ST
ELMONT
NY
110033926
Practice Location Phone/Fax
| Phone: | 5166430520 |
| Fax: |
Provider Mailing Location
11555 237TH ST
ELMONT
NY
110033926
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |