Healthcare Provider Details

I. General information

NPI: 1871419127
Provider Name (Legal Business Name): MEND PHYSICIAN SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 KILMER RD # 1089
EDISON NJ
08817-2432
US

IV. Provider business mailing address

2025 GUADALUPE ST STE 260
AUSTIN TX
78705-5642
US

V. Phone/Fax

Practice location:
  • Phone: 917-382-0243
  • Fax: 315-273-6048
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BEATTY
Title or Position: OWNER
Credential: DO
Phone: 917-382-0243