Provider Demographics
NPI:1104089705
Name:MENIER, DIANE H (RPAC)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:H
Last Name:MENIER
Suffix:
Gender:F
Credentials:RPAC
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Mailing Address - Street 1:435 MONTAUK HWY
Mailing Address - Street 2:SOUTH BAY HEMATOLOGY/ ONCOLOGY PC
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11754
Mailing Address - Country:US
Mailing Address - Phone:631-422-4545
Mailing Address - Fax:
Practice Address - Street 1:435 MONTAUK HWY
Practice Address - Street 2:SOUTH BAY HEMATOLOGY/ ONCOLOGY PC
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11754
Practice Address - Country:US
Practice Address - Phone:631-422-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY004965363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical