Provider Demographics
NPI:1497890727
Name:MENGES, JULIE S (LDN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:S
Last Name:MENGES
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2683
Mailing Address - Country:US
Mailing Address - Phone:508-896-7279
Mailing Address - Fax:
Practice Address - Street 1:78 CROWELL RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:MA
Practice Address - Zip Code:02633-1966
Practice Address - Country:US
Practice Address - Phone:508-945-0187
Practice Address - Fax:508-945-5864
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA970133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist