Provider Demographics
NPI:1720168529
Name:MENIKOFF, HOWARD (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:MENIKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8856
Mailing Address - Country:US
Mailing Address - Phone:212-473-7892
Mailing Address - Fax:212-473-7856
Practice Address - Street 1:2 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8856
Practice Address - Country:US
Practice Address - Phone:212-473-7892
Practice Address - Fax:212-473-7856
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173924207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0420423Medicaid
35E071Medicare ID - Type Unspecified
A62442Medicare UPIN