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General NPI Number Information
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NPI Number | 1104802925
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Entity Type | Individual
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Provider Name | HENRY N MENSACK P.A.-C
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 329 MULLET RUN
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City | MILFORD
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State | DE
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Zip | 19963-5373
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Country | US
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Telephone | 410-749-4154
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Fax | 410-860-9583
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Provider Business Mailing Address
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Address Line | PO BOX 607
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City | GEORGETOWN
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State | DE
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Zip | 19947-0607
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Country | US
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Telephone | 302-424-4141
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Fax | 302-422-6506
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0000229
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License Number State | DE
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