Individual
MELISSA BULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
445 WATERVLIET-SHAKER ROAD, LATHAM, NY 12110-4697
(518) 785-5511
Mailing address
445 WATERVLIET-SHAKER ROAD, LATHAM, NY 12110-4697
(518) 785-5511
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
534334
NY
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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