Organization
MELISSA STOCKMAN ADULT CARE NP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SONYA STOCKMAN MS, RN CS, ANP, PNP (OWNER)
(631) 758-5635
Entity
Organization
Contact information
Practice address
41 GREENPORT AVE, MEDFORD, NY 11763-3601
(631) 758-5635
Mailing address
41 GREENPORT AVE, MEDFORD, NY 11763-3601
(631) 758-5635
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302133-1
NY
363LP0200X
Pediatric Nurse Practitioner
F381245-1
NY
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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