MESIDOR CONSULTING SERVICES LLC NPI 1457067688

NPI Information

NPI: 1457067688
Provider Name: MESIDOR CONSULTING SERVICES LLC
Classification: Nurse Practitioner - 363LA2200X
Specialization: Adult Health
Entity Type: Organization
Address: 1400 WANTAGH AVE
WANTAGH, NY
ZIP 11793
Phone: (551) 275-5674

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NPI Details

MESIDOR CONSULTING SERVICES LLC is an adult health nurse practitioner in Wantagh, NY. MESIDOR CONSULTING SERVICES LLC NPI is 1457067688. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1400 WANTAGH AVE
WANTAGH, NY
ZIP 11793-257
Phone: (551) 275-5674

The provider's authorized official is Valessa Mesidor .
The authorized official title is Owner and has the following contact phone number (551) 275-5674.

The enumeration date for this NPI number is 1/31/2023 and was last updated on 1/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	06885978	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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