Healthcare Provider Details

I. General information

NPI: 1275603326
Provider Name (Legal Business Name): EVAN MEINER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NSUH-DEPT OF EMERGENCY MEDICINE 300 COMMUNITY DRIVE
MANHASSET NY
11030
US

IV. Provider business mailing address

NSUH-DEPT OF EMERGENCY MEDICINE 300 COMMUNITY DRIVE
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-3090
  • Fax:
Mailing address:
  • Phone: 516-719-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number220598
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: