Provider Demographics
NPI:1134578461
Name:MENEI, SAMUEL JAMES (OD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JAMES
Last Name:MENEI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 W FLAGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3647
Mailing Address - Country:US
Mailing Address - Phone:302-312-9725
Mailing Address - Fax:
Practice Address - Street 1:223 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1449
Practice Address - Country:US
Practice Address - Phone:302-376-4190
Practice Address - Fax:302-376-5644
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003188152W00000X
NJ27OA00667000152W00000X
DEI3-0001393152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist