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General NPI Number Information
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NPI Number | 1497741532
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Entity Type | Individual
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Provider Name | ALI MENDELSON MD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 800-879-2467
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 CIVIC CENTER BLVD STE M975
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 233946
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD468483
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | MD468483
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License Number State | PA
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