MEDICARE: CAROLINE MENDEL PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	022217	NY

General Provider Information

NPI Number	:	1467976134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE MENDEL PSYD

Provider Business Mailing Address
First Line	:	445 PARK AVE FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-8649
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	CHILD MIND INSTITUTE
Second Line	:	445 PARK AVE FL 2
City	:	NEW YORK
State	:	NY
Zip	:	10022-8649
Country	:	US
Telephone Number	:	646-625-4321
Fax Number	:	646-625-4348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	08/03/2017

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Directions to “ CAROLINE MENDEL PSYD” Practice Location

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