MEDICARE: MS. FLORE MARIE MENARDY NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F40029	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F400929	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457401952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FLORE MARIE MENARDY NP

Provider Business Mailing Address
First Line	:	476 BURLINGHAM RD
Second Line	:
City	:	BLOOMINGBURG
State	:	NY
Zip	:	12721-5011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	476 BURLINGHAM ROAD
Second Line	:
City	:	BLOOMINGBURG
State	:	NY
Zip	:	12721
Country	:	US
Telephone Number	:	917-744-4006
Fax Number	:

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	05/16/2022

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