Provider Demographics
NPI:1184687097
Name:MENE, MATTHEW P (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:P
Last Name:MENE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4100 DUFF PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1324
Mailing Address - Country:US
Mailing Address - Phone:516-520-8080
Mailing Address - Fax:516-520-8877
Practice Address - Street 1:4100 DUFF PL
Practice Address - Street 2:SUITE A
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1324
Practice Address - Country:US
Practice Address - Phone:516-520-8080
Practice Address - Fax:516-520-8877
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY185972208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B17332Medicare UPIN