Individual
MELISSA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
450 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1118
(516) 672-5836
Mailing address
450 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1118
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F433417-01
NY
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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