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General NPI Number Information
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NPI Number | 1700898830
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Entity Type | Individual
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Provider Name | JOHN P MENZEL OD
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 141 S MAIN ST
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City | WILKES BARRE
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State | PA
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Zip | 18701
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Country | US
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Telephone | 570-825-3491
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Fax | 570-822-5654
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Provider Business Mailing Address
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Address Line | 200 MIFFLIN AVE
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City | SCRANTON
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State | PA
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Zip | 18503
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Country | US
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Telephone | 570-342-3145
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Fax | 570-344-1309
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001358
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License Number State | PA
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