Provider Demographics
NPI:1154310316
Name:MESNICK, NEAL ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ADAM
Last Name:MESNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6307
Mailing Address - Country:US
Mailing Address - Phone:212-414-9508
Mailing Address - Fax:212-414-8509
Practice Address - Street 1:5 W 16TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6307
Practice Address - Country:US
Practice Address - Phone:212-414-9508
Practice Address - Fax:212-414-8509
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2186832081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH51869Medicare UPIN
NY2I1371Medicare PIN