Individual
JOHN P MENZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
141 S MAIN ST, WILKES BARRE, PA 18701
(570) 825-3491
(570) 822-5654
Mailing address
200 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
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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