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Individual

MELVIN GEORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, PMHNP-BC

Contact information

Practice address
159 CARLETON AVE, CENTRAL ISLIP, NY 11722-4172
(631) 650-2510
Mailing address
40 GREYBARN LN APT 312, AMITYVILLE, NY 11701-2265

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
781234
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405536-01
NY

Other

Enumeration date
02/29/2024
Last updated
02/29/2024
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