MEDICARE: DEMYANA N MEHANNY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03824400	NJ

General Provider Information

NPI Number	:	1639038276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEMYANA N MEHANNY

Provider Business Mailing Address
First Line	:	1093 AVENUE C
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-3339
Country	:	US
Telephone Number	:	201-535-0440
Fax Number	:	201-353-0420

Provider Business Practice Location Address
First Line	:	1093 AVENUE C
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-3339
Country	:	US
Telephone Number	:	201-535-0440
Fax Number	:	201-353-0420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ DEMYANA N MEHANNY ” Practice Location

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