Provider Demographics
NPI:1730531088
Name:MENDEZ, MANESI GLORIVI (CPNP, RN, BSN)
Entity type:Individual
Prefix:
First Name:MANESI
Middle Name:GLORIVI
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:CPNP, RN, BSN
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Other - Middle Name:
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Mailing Address - Street 1:400 FORT WASHINGTON AVE APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6837
Mailing Address - Country:US
Mailing Address - Phone:212-923-8500
Mailing Address - Fax:212-923-6718
Practice Address - Street 1:400 FORT WASHINGTON AVE APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033
Practice Address - Country:US
Practice Address - Phone:212-923-8500
Practice Address - Fax:212-923-6718
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY706473-1163W00000X
NYF382735-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse