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Individual

JOHN P MENCHINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1131 DELAWARE AVE, BUFFALO, NY 14209-1603
(716) 884-0230
(716) 884-2415
Mailing address
1131 DELAWARE AVE, BUFFALO, NY 14209-1603
(716) 884-0230
(716) 884-2415

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
101753
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010116801
UNIVERA
NY
01
005062501
BLUC CROSS/CB
NY
05
00652882
NY
01
1200231
INDEPENDENT HEALTH ASSOC
NY
Enumeration date
12/13/2005
Last updated
11/28/2011
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