Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 11905 | NH |
NPI | 1114915428 |
---|---|
Provider Name | Sonita E Mendoza |
First Address | Dover, NH 03820-2526 |
Second Address | Dover, NH 03820-5933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 20/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1114915428 | (05) | ME |
3076283 | (05) | NH |
H98162 | (02) |