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General NPI Number Information
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NPI Number | 1184786246
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Entity Type | Individual
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Provider Name | MICHAEL ERIC MARQUEZ MENCIAS MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 100 QUENTIN ROOSEVELT BLVD STE 104
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City | GARDEN CITY
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State | NY
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Zip | 11530-4824
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Country | US
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Telephone | 516-239-2400
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Fax | 516-536-0369
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Provider Business Mailing Address
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Address Line | 100 QUENTIN ROOSEVELT BLVD STE 104
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City | GARDEN CITY
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State | NY
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Zip | 11530-4824
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Country | US
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Telephone | 516-239-2400
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Fax | 516-536-0369
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 240781
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License Number State | NY
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