Provider Demographics
NPI:1194964460
Name:MENDELOW, CARA (PHD)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:
Last Name:MENDELOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W 72ND ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3419
Mailing Address - Country:US
Mailing Address - Phone:917-628-8262
Mailing Address - Fax:212-496-1060
Practice Address - Street 1:15 W 72ND ST APT 1R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3419
Practice Address - Country:US
Practice Address - Phone:917-628-8262
Practice Address - Fax:212-496-1060
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017911103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist