Individual
NICHOLAS MELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2338
(315) 426-3600
Mailing address
512 WHITTIER AVE, SYRACUSE, NY 13204-2525
(315) 679-0463
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
892948
NY
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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