# GERALD S MENNIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1003902156
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 82673 | NY | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 10/17/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00121706 | — | NY |
| 01 | — | 23228P | HIP HEALTH PLAN NY | NY |
| 01 | — | 4096908 | AETNA | NY |
| 01 | — | 48Z791 | EMPIRE BLUE CROSS BLUE SH | NY |
| 01 | — | OH4152 | HEALTHNET | NY |
| 01 | — | WS005 | OXFORD HEALTH PLANS | NY |