Provider Demographics
NPI:1467573253
Name:MENIA, TODD (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:MENIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-302-8610
Practice Address - Street 1:30 COLUMBIA ST
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3906
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-302-8610
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2016-07-01
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Provider Licenses
StateLicense IDTaxonomies
NY208183207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141338471OtherUNITED HEALTH CARE
NY03002375Medicaid
NYA400136155OtherPTAN
NY03002375Medicaid