MEDICARE: DR. CORINNE DECEMBER MENN D.O.

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	207V00000X	Obstetrics & Gynecology Physician	234864	NY

General Provider Information

NPI Number	:	1700907607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORINNE DECEMBER MENN D.O.

Provider Business Mailing Address
First Line	:	16 S BEDFORD RD
Second Line	:	SUITE 3E
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3464
Country	:	US
Telephone Number	:	914-238-0350
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 S BEDFORD RD
Second Line	:	SUITE 3E
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3464
Country	:	US
Telephone Number	:	914-238-0350
Fax Number	:

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	12/14/2012

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