Provider Demographics
NPI:1023635208
Name:MENG, CANDICE HAOYU (OD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:HAOYU
Last Name:MENG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 QUEENS PLZ N APT 22G
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3808 UNION ST STE 3P02
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5543
Practice Address - Country:US
Practice Address - Phone:929-303-3575
Practice Address - Fax:929-303-3576
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-03
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009156152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist