Individual
CAROL MELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CONWAY CT, TROY, NY 12180-2108
(518) 274-6525
(518) 274-6511
Mailing address
112 ULRICH DR, ROTTERDAM JUNCTION, NY 12150-9763
(518) 274-6525
(518) 274-6511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
563854
NY
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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