Individual
MELISSA ANNE AZAULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 MAIN ST FL 4, BUFFALO, NY 14203-1009
(716) 323-0034
(716) 323-0292
Mailing address
1001 MAIN ST FL 5, BUFFALO, NY 14203-1009
(716) 323-0034
(716) 323-0292
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
194829
NY
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
194829
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000524267006
BC/BS
—
05
—
0018526310001
—
PA
05
—
01654044
—
NY
01
—
040426000781
DIDELIS
—
01
—
3008167
IHA
—
Enumeration date
04/24/2006
Last updated
10/07/2022
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