Individual
MELISSA A DERENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
102 TECHNOLOGY DR, SUITE 120, BUTLER, PA 16001-1782
(724) 482-0090
(724) 482-0093
Mailing address
6008 RED TAIL LN, GIBSONIA, PA 15044-6046
(724) 482-0090
(724) 482-0093
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD426870
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013408410003
—
PA
01
—
1186970001
DME
PW
01
—
P00250791
RAILROAD MEDICARE
PA
Enumeration date
11/01/2006
Last updated
07/08/2007
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