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Individual
PAUL MENGE
Active
Individual
PAUL MENGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
155327-1
NY
207QA0000X
Adolescent Medicine (Family Medicine) Physician
155327-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01160356
—
NY
Enumeration date
10/25/2006
Last updated
12/07/2007
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