Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 21643 | NH |
N | 207Q00000X | Family Doctor | MT202492 | PA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 21643 | NH |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD456243 | PA |
NPI | 1003169814 |
---|---|
Provider Name | Dr. Ana V Castellanos Mendez |
First Address | Concord, NH 03301-2598 |
Second Address | Concord, NH 03301-2598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2012 |
Last Update Date | 12/10/2021 |