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Individual
MELISSA FANTON
Active
Individual
MELISSA FANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011387
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000529192003
BCBS
NY
05
—
03031436
—
NY
01
—
1902998974
UNIVERA
NY
01
—
9514014
IHA
NY
01
—
P00731283
RAILROAD MEDICARE
NY
Enumeration date
09/28/2006
Last updated
08/27/2009
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