MEDICARE: ALEC MENGE

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	225700000X	Massage Therapist	026605-01	NY

General Provider Information

NPI Number	:	1265201875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEC MENGE

Provider Business Mailing Address
First Line	:	9508 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9711 3RD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-7717
Country	:	US
Telephone Number	:	702-907-7171
Fax Number	:

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

Provider Enumeration Date	:	12/22/2023
Last Update Date	:	12/22/2023

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Directions to “ ALEC MENGE ” Practice Location

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