Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 240781 | NY |
NPI | 1184786246 |
---|---|
Provider Name | Dr. Michael Eric Marquez Mencias |
First Address | East Elmhurst, NY 11370-1138 |
Second Address | East Elmhurst, NY 11370-1138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 16/03/2011 |