Glenn J Mendoza, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

148338 Issued in NY

Practice address

255 Lafayette Ave
Suffern, NY 10901-4817

Phone

(914) 493-8558

Fax

(914) 493-1488

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1205823796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 GRASSLANDS RD",
            "address_2": "MUNGER PAVILION STE 120",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951652",
            "telephone_number": "914-493-8558",
            "fax_number": "914-493-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014817",
            "telephone_number": "914-493-8558",
            "fax_number": "914-493-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "GLENN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "148338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7414706",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00992998",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer McNamara, FNP
• Sandra Ann Meagher
• Felix A Medina, M.D.
• Lauren Melder-Beers, RN
• James C. Melillo, DDS
• Patricia Mennite, LPN
• Melissa Adair Mercer, LPN
• Dianne Merenyi, RN
• Jacqueline Merrell, LNP
• Metropolitan Cardiology Consultants, LLC

• Neonatal-Perinatal Medicine Physician in Suffern, NY
• Providers in Suffern, NY by specialty
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.