MEDICARE: RANDI BROOKE MENDEL

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1508717844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI BROOKE MENDEL

Provider Business Mailing Address
First Line	:	17 AMANDA CT
Second Line	:
City	:	CORTLANDT MNR
State	:	NY
Zip	:	10567-6407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2488 GRAND CONCOURSE STE 2000
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-5203
Country	:	US
Telephone Number	:	644-663-2255
Fax Number	:

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

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “ RANDI BROOKE MENDEL ” Practice Location

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