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General NPI Number Information
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NPI Number | 1881670784
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Entity Type | Individual
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Provider Name | SERGE MENKIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 311 NEWARK AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07302
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Country | US
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Telephone | 201-533-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 670 N BEERS ST
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City | HOLMDEL
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State | NJ
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Zip | 07733-1516
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Country | US
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Telephone | 732-226-6603
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Fax |
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 25MA08003800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MA08003800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 247604
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD423287
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 25MA08003800
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License Number State | NJ
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