Provider Demographics
NPI:1912267022
Name:MARTIN MENOSKY MD LLC
Entity Type:Organization
Organization Name:MARTIN MENOSKY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-687-2430
Mailing Address - Street 1:564 MILL PARK DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-7744
Mailing Address - Country:US
Mailing Address - Phone:740-687-2430
Mailing Address - Fax:740-687-2807
Practice Address - Street 1:564 MILL PARK DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7744
Practice Address - Country:US
Practice Address - Phone:740-687-2430
Practice Address - Fax:740-687-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty