Healthcare Provider Details

I. General information

NPI: 1114716370
Provider Name (Legal Business Name): ANNIE MENDEZ CF-SLP, TSSLD, BE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AMBER LN
OYSTER BAY NY
11771-3115
US

IV. Provider business mailing address

2440 HUNTER AVE APT 8G
BRONX NY
10475-5663
US

V. Phone/Fax

Practice location:
  • Phone: 347-770-4009
  • Fax:
Mailing address:
  • Phone: 347-360-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: