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General NPI Number Information
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NPI Number | 1417753203
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Entity Type | Individual
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Provider Name | SPENCER MENDOZA PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 95 MADISON AVE STE A11
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6092
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Country | US
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Telephone | 973-435-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 3 AMBLER WAY
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City | PARSIPPANY
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State | NJ
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Zip | 07054-1401
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Country | US
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Telephone | 914-843-1489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA02321000
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License Number State | NJ
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