Provider Demographics
NPI:1548081110
Name:MENDOZA, ROWENA E (RN)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:E
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:ROWENA
Other - Middle Name:CARLOS
Other - Last Name:ESTRELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6111 172ND ST FL MEADOWS1
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2027
Mailing Address - Country:US
Mailing Address - Phone:516-728-8804
Mailing Address - Fax:
Practice Address - Street 1:2811 QUEENS PLZ N FL 5
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4172
Practice Address - Country:US
Practice Address - Phone:718-391-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY913118163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool