Provider Demographics
NPI:1700907607
Name:MENN, CORINNE DECEMBER (DO)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:DECEMBER
Last Name:MENN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S BEDFORD RD
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3464
Mailing Address - Country:US
Mailing Address - Phone:914-238-0350
Mailing Address - Fax:
Practice Address - Street 1:16 S BEDFORD RD
Practice Address - Street 2:SUITE 3E
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3464
Practice Address - Country:US
Practice Address - Phone:914-238-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234864207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology