Provider Demographics
NPI:1477543650
Name:MESHNICK, JOEL A (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:MESHNICK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2574 HEWLETT LN
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4413
Mailing Address - Country:US
Mailing Address - Phone:516-781-5440
Mailing Address - Fax:
Practice Address - Street 1:2574 HEWLETT LN
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-4413
Practice Address - Country:US
Practice Address - Phone:516-781-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003957213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00904045Medicaid
NYP40992Medicare ID - Type UnspecifiedMEDICARE
NY00904045Medicaid