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NPI Code Detail

MEDICARE: TYSHAWNA MENDEZ

MEDICARE:   TYSHAWNA  MENDEZ
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
1164W00000XLicensed Practical Nurse346212NY

General Provider Information

NPI Number : 1760188767
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYSHAWNA MENDEZ
Provider Business Mailing Address
First Line : 972 E 88TH ST APT 101
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3949
Country : US
Telephone Number : 347-972-2772
Fax Number :
Provider Business Practice Location Address
First Line : 972 E 88TH ST APT 101
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3949
Country : US
Telephone Number : 347-972-2772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2023
Last Update Date : 02/01/2023

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Directions to “ TYSHAWNA MENDEZ ” Practice Location

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