Provider Demographics
NPI:1407832835
Name:MESNICK, DEBRA MAYER (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:MAYER
Last Name:MESNICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E 80TH ST
Mailing Address - Street 2:APT 2 C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:559 GRAMATAN AVE
Practice Address - Street 2:STE 203
Practice Address - City:MT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-2155
Practice Address - Country:US
Practice Address - Phone:914-663-0151
Practice Address - Fax:914-663-0154
Is Sole Proprietor?:No
Enumeration Date:2005-12-18
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225793208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics