Individual
MELLISA GEORGETTE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 E 55TH ST, BROOKLYN, NY 11234-2418
(917) 701-5277
Mailing address
1180 E 55TH ST, BROOKLYN, NY 11234-2418
(917) 701-5277
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
341954
NY
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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