MEDICARE: CANDICE HAOYU MENG OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	009156	NY

General Provider Information

NPI Number	:	1023635208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE HAOYU MENG OD

Provider Business Mailing Address
First Line	:	2911 QUEENS PLZ N APT 22G
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4043
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3808 UNION ST STE 3P02
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5543
Country	:	US
Telephone Number	:	929-303-3575
Fax Number	:	929-303-3576

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2020
Last Update Date	:	12/06/2022

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