Individual
MELITTA MENDONCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4979 HARLEM RD, AMHERST, NY 14226-2547
(716) 923-4380
(716) 923-4384
Mailing address
4979 HARLEM RD, AMHERST, NY 14226-2547
(716) 923-4380
(716) 923-4384
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04542114
—
NY
Enumeration date
06/13/2016
Last updated
04/04/2017
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