Provider Demographics
NPI:1194783605
Name:MENDEZ, CESAR M (DPM)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:M
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 WILLIAMS ST
Mailing Address - Street 2:STE 2
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7446
Mailing Address - Country:US
Mailing Address - Phone:413-499-9933
Mailing Address - Fax:413-499-3943
Practice Address - Street 1:740 WILLIAMS ST
Practice Address - Street 2:STE 2
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7446
Practice Address - Country:US
Practice Address - Phone:413-499-9933
Practice Address - Fax:413-499-3943
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2025213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0358428Medicaid
LX5227Medicare UPIN
U55803Medicare UPIN
MAY75001Medicare ID - Type Unspecified