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General NPI Number Information
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NPI Number | 1831450659
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Entity Type | Individual
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Provider Name | MARY C. MENARD DVM
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Gender | Female
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 4321 STATE ROUTE 22
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City | SALEM
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State | NY
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Zip | 12865-3427
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Country | US
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Telephone | 518-854-3005
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Fax | 518-854-3272
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Provider Business Mailing Address
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Address Line | 4321 STATE ROUTE 22
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City | SALEM
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State | NY
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Zip | 12865-3427
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Country | US
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Telephone | 518-854-3005
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Fax | 518-854-3272
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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 | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 75.007608
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License Number State | NY
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