Provider Demographics
NPI:1992471775
Name:MENDES, FILIPE SILVA (NP)
Entity type:Individual
Prefix:
First Name:FILIPE
Middle Name:SILVA
Last Name:MENDES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 ROCKLAND DR
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1436
Mailing Address - Country:US
Mailing Address - Phone:516-351-4361
Mailing Address - Fax:
Practice Address - Street 1:300 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2161
Practice Address - Country:US
Practice Address - Phone:516-599-8280
Practice Address - Fax:516-706-9599
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310372363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health