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General NPI Number Information
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NPI Number | 1750604377
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Entity Type | Individual
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Provider Name | EMILY MENGES P.A.
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Gender | Female
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 5501 OLD YORK RD MOSS BUILDING 3RD FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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Country | US
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Telephone | 215-456-3930
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Fax | 215-456-1432
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Provider Business Mailing Address
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Address Line | 1999 SPROUL RD STE 25
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City | BROOMALL
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State | PA
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Zip | 19008-3508
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Country | US
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Telephone | 610-353-6400
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Fax | 610-356-1204
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA053174
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License Number State | PA
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