Individual
DR. MICHAEL ANTHONY MENNELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
496 SMITHTOWN BYP, SUITE LL1, SMITHTOWN, NY 11787-5005
(631) 724-6333
Mailing address
496 SMITHTOWN BYP, SUITE LL1, SMITHTOWN, NY 11787-5005
(631) 793-9177
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
191160
NY
2084P0804X
Child & Adolescent Psychiatry Physician
191160
NY
Other
Enumeration date
03/10/2007
Last updated
09/29/2023
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