Individual ProviderEric John MenesesLicensed Practical NurseNursing Service ProvidersPractice Address15 Victoria Cir, East Patchogue, NY 11772-4530(631) 714-4959PECOS EnrollmentBased on the most recent information from CMS, provider Eric John Meneses does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1962616649Provider TypeIndividualFull NameMeneses, Eric JohnTitleMr.CredentialLPNGenderMaleSole ProprietorYesEnumeration Date5/10/2007Last Updated7/9/2007Contact InformationPractice LocationPractice Address15 Victoria Cir, East Patchogue, NY 11772-4530Phone(631) 714-4959FaxUnlisted FaxMailing LocationMailing Address15 Victoria Cir, East Patchogue, NY 11772-4530Phone(631) 714-4959FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense225130New YorkProvider IdentifiersIDDescriptionIssuerID01898695DescriptionMedicaidIssuerUnlistedNew York