Individual
DR. GUSTAVO R MELAMEDOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2531 30TH RD STE 1A, ASTORIA, NY 11102-2624
(718) 267-1102
(718) 267-0847
Mailing address
70 SHRUB HOLLOW RD, ROSLYN, NY 11576-3110
(516) 361-9520
(718) 267-0847
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
148336
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00767359
—
NY
Enumeration date
08/14/2006
Last updated
06/22/2023
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