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Individual

MELANIE J MARIEN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RPA C

Contact information

Practice address
180 PARK CLUB LN, STE 100, WILLIAMSVILLE, NY 14221-5263
(716) 839-9402
(716) 839-3570
Mailing address
550 ORCHARD PARK RD, STE A105, WEST SENECA, NY 14224-2646
(716) 677-6000
(716) 677-6006

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006802 1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026522501
UNIVERA HEALTHCARE
01
000570154002
BLUE CROSS BLUE SHIELD
NY
05
02107399
NY
01
9511989
INDEPENDENT HEALTH
NY
Enumeration date
12/19/2005
Last updated
07/08/2007
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