Individual
MRS. MELODIE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12620 133RD AVE, SOUTH OZONE PARK, NY 11420-3310
(917) 535-7157
Mailing address
12620 133RD AVE, SOUTH OZONE PARK, NY 11420-3310
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308785
NY
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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