Organization
GEETHA MENON MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEETHA MENON M.D. (PRESIDENT)
(516) 216-1781
Entity
Organization
Contact information
Practice address
1983 MARCUS AVE STE E132, LAKE SUCCESS, NY 11042-1030
(516) 216-1781
Mailing address
1983 MARCUS AVE STE E132, LAKE SUCCESS, NY 11042-1030
(516) 216-1781
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
234465
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
234465
NY STATE LIC
NY
Enumeration date
04/16/2009
Last updated
06/16/2009
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