MEDICARE: JASON MENDELSOHN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	25MA10941400	NJ

General Provider Information

NPI Number	:	1083118913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON MENDELSOHN MD

Provider Business Mailing Address
First Line	:	7 DRUID HILL DRIVE
Second Line	:
City	:	PARSIPPANY
State	:	NJ
Zip	:	07054
Country	:	US
Telephone Number	:	973-738-7466
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 HUNTER ST STE 206
Second Line	:
City	:	LODI
State	:	NJ
Zip	:	07644-1608
Country	:	US
Telephone Number	:	973-473-3896
Fax Number	:	973-473-4806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2018
Last Update Date	:	08/06/2021

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Directions to “ JASON MENDELSOHN MD” Practice Location

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