Individual
ANDRES MAURICIO MELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPAC, MPAS
Contact information
Practice address
55 N MAIN ST, FREEPORT, NY 11520-2243
(516) 377-8014
(516) 377-8017
Mailing address
55 N MAIN ST, FREEPORT, NY 11520-2243
(516) 377-8014
(516) 377-8017
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016262
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016262
LICENSE
NY
Enumeration date
11/16/2012
Last updated
11/16/2012
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