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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679579585 | NPPES |
| New York | MEDICAID | 01870800 |
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