Provider Demographics
NPI:1861558926
Name:MENGE, ERICH EMMANUEL (DC)
Entity type:Individual
Prefix:DR
First Name:ERICH
Middle Name:EMMANUEL
Last Name:MENGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 LINTON BLVD., STE 9A
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5315
Mailing Address - Country:US
Mailing Address - Phone:561-632-2092
Mailing Address - Fax:561-496-6675
Practice Address - Street 1:4801 LINTON BLVD., STE 9A
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5315
Practice Address - Country:US
Practice Address - Phone:561-632-2092
Practice Address - Fax:561-496-6675
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009561111N00000X
FLCH 9560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL161610170OtherUNITED HEALTH CARE
FL88701OtherBCBS
NYP010009561OtherBLUE CROSS BLUE SHIELD
FLCH 9560OtherWORKERS COMPENSATION
FL161610170OtherAETNA
NY7209250OtherAETNA
NYCO9561-4BOtherWORKERS COMPENSATION
NYP010009561OtherBLUE CHOICE
NY009561OtherPREFERRED CARE
FL161610170OtherCIGNA
FL161610170OtherAETNA
FL88701OtherBCBS
NYCO9561-4BOtherWORKERS COMPENSATION