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NPI Code Detail

MEDICARE: EVELYN JOHANNA MENDEZ

MEDICARE: EVELYN JOHANNA 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
1171M00000XCase Manager/Care CoordinatorNY

General Provider Information

NPI Number : 1942145339
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN JOHANNA MENDEZ
Provider Business Mailing Address
First Line : 154 W 84TH ST APT 305
Second Line :
City : NEW YORK
State : NY
Zip : 10024-4695
Country : US
Telephone Number : 917-815-1934
Fax Number :
Provider Business Practice Location Address
First Line : 3004 146TH ST
Second Line :
City : FLUSHING
State : NY
Zip : 11354-2324
Country : US
Telephone Number : 917-815-1934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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Directions to “ EVELYN JOHANNA MENDEZ ” Practice Location

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