Individual
MELISSA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
297 NORMA AVE, WEST ISLIP, NY 11795-1512
(631) 297-4684
Mailing address
297 NORMA AVE, WEST ISLIP, NY 11795-1512
(631) 297-4684
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
749611
NY
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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