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General NPI Number Information
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NPI Number | 1790480465
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Entity Type | Individual
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Provider Name | KATHERINE MASSIEL HERNANDEZ MENDEZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | ONE COOPER PLAZA
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City | CAMDEN
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State | NJ
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Zip | 08103
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Country | US
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Telephone | 856-342-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2141 ROUTE 38 W-1207
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City | CHERRY HILL
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State | NJ
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Zip | 08002
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Country | US
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Telephone | 856-802-7442
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | P24-00817
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License Number State | NJ
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