Individual
IVY TAN MENESES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 COTTONWOOD DR, COMMACK, NY 11725-2420
(631) 875-1851
Mailing address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(631) 875-1851
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
431560
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
F431560-01
NY
Other
Enumeration date
08/28/2019
Last updated
11/03/2023
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