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Individual

MELISSA E MITKOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5 PALISADES DR, STE100, ALBANY, NY 12205-6433
(518) 438-4493
(518) 438-5803
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F430108-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02049558
NY
Enumeration date
09/13/2005
Last updated
05/14/2021
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