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General NPI Number Information
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NPI Number | 1902174394
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Entity Type | Organization
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Legal Business Name | GREGORY J. MENIO, MD PC
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 300 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3012
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Country | US
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Telephone | 570-476-2101
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Fax | 570-476-5646
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Provider Business Mailing Address
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Address Line | 300 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3012
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Country | US
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Telephone | 570-476-2101
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Fax | 570-476-5646
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY JOHN MENIO SR.
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Credential | M.D.
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Telephone | 570-476-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD036469E
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License Number State | PA
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