Healthcare Provider Details

I. General information

NPI: 1437413036
Provider Name (Legal Business Name): JAMIE JIANMIN MENG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 49TH ST STE 2
BROOKLYN NY
11220-2481
US

IV. Provider business mailing address

4802 10TH AVE CARDIOLOGY
BROOKLYN NY
11219-2916
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-1500
  • Fax: 718-635-5942
Mailing address:
  • Phone: 718-283-1500
  • Fax: 718-635-5942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number290578
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number290578
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number290578
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: