Mentis, Sue

Mentis, Sue is an individual health care provider with primary practice located at 1500 Ny-112 , Port Jefferson Station NY 11776-4515. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Mentis, Sue can be contacted via phone (631) 828-3400.

Contact Information

Primary practice address
1500 Ny-112 Port Jefferson Station NY 11776-4515
Phone: (631) 828-3400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 209011 New York

Profile Details

NPI number 1679579585
LBN Legal business name Mentis, Sue
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Mar 31st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679579585 NPPES
New York MEDICAID 01870800

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