Individual
ANDY MELENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8302
Mailing address
14202 20TH AVE, FLUSHING, NY 11351-3000
(718) 559-0516
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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