Individual
JOHN P MENZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001358
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072089
FIRST PRIORITY HEALTH
—
01
—
18730
GEISINGER HEALTH PLAN
—
01
—
410034667
RAILROAD MEDICARE
—
01
—
506550
AETNA
—
01
—
ME078262
HIGH MARK BLUE SHIELD
—
01
—
OEG001358
LICENSE
—
Enumeration date
08/13/2006
Last updated
01/11/2010
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