Mendonca, Carroll Ann
Mendonca, Carroll Ann is an individual health care provider with primary practice located at 12711 111Th Ave , South Ozone Park NY 11420-1604. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Mendonca, Carroll Ann can be contacted via phone (718) 322-7967.Contact Information
Primary practice address
12711 111Th Ave
South Ozone Park NY 11420-1604
Phone: (718) 322-7967
Fax: (718) 738-2236
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 022988 | New York |
Profile Details
| NPI number | 1871605337 |
|---|---|
| LBN Legal business name | Mendonca, Carroll Ann |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871605337 | NPPES |
| New York | Other | XC2685 | HEALTHNET |
| New York | Other | 69520 | HEALTHNET |
| New York | Other | GQ537 | HEALTHNET |
| New York | Other | 126019P | HEALTHNET |
| New York | Other | 98123701 | HEALTHNET |
| New York | Other | 022988-A81 | HEALTHNET |
| New York | MEDICAID | 02285481 | HEALTHNET |
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