Individual
MR. MICHAEL ROBERT MENASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
637 5TH AVE, BROOKLYN, NY 11215-5434
(718) 499-4260
(718) 499-6007
Mailing address
637 5TH AVE, BROOKLYN, NY 11215-5434
(718) 499-4260
(718) 499-6007
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C0053311
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01050339
—
NY
Enumeration date
03/29/2006
Last updated
11/08/2017
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