Individual
ANU PAUL VANMELIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 233-9421
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 233-9421
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F310943-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801509351
—
NY
Enumeration date
12/29/2022
Last updated
01/31/2023
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