Provider Demographics
NPI:1831450659
Name:MENARD, MARY C (DVM)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:MENARD
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 STATE ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:12865-3427
Mailing Address - Country:US
Mailing Address - Phone:518-854-3005
Mailing Address - Fax:518-854-3272
Practice Address - Street 1:4321 STATE ROUTE 22
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NY
Practice Address - Zip Code:12865-3427
Practice Address - Country:US
Practice Address - Phone:518-854-3005
Practice Address - Fax:518-854-3272
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY75.007608174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian