Healthcare Provider Details

I. General information

NPI: 1295783041
Provider Name (Legal Business Name): HELEN DONNA MENGE CNM, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 ALBANY SHAKER RD
LATHAM NY
12110-1409
US

IV. Provider business mailing address

237 GRAY RD
MAYFIELD NY
12117-3504
US

V. Phone/Fax

Practice location:
  • Phone: 518-220-2022
  • Fax: 518-220-9263
Mailing address:
  • Phone: 518-661-5273
  • Fax: 518-220-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF420702-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360460-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001132-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: