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General NPI Number Information
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NPI Number | 1255425948
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Entity Type | Individual
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Provider Name | NELSON SOCORRO MENEZES M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 186 JORALEMON ST SUITE 1002
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City | BROOKLYN
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State | NY
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Zip | 11201-4356
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Country | US
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Telephone | 718-625-4100
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Fax | 718-625-4900
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Provider Business Mailing Address
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Address Line | 75 88TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11209
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Country | US
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Telephone | 718-238-2249
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Fax | 718-250-8460
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 194948
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License Number State | NY
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