Provider Demographics
NPI:1982812566
Name:MENG, STEPHANY ANN (DC)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:ANN
Last Name:MENG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2309
Mailing Address - Country:US
Mailing Address - Phone:631-728-8545
Mailing Address - Fax:631-728-1242
Practice Address - Street 1:147 W MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2309
Practice Address - Country:US
Practice Address - Phone:631-728-8545
Practice Address - Fax:631-728-1242
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO3234-4OtherWORKERS COMPENSATION
NYT52443Medicare UPIN
NYCO3234-4OtherWORKERS COMPENSATION