Melissa Mediate

NPI #1093205205 in Commack, New York

Provider Information

NPI Number: 1093205205
Entity Type: Individual
Name: Melissa Mediate
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: May 14, 2018
Last Updated: May 14, 2018

Practice Location

Address: 9 SMITHS LN
City: Commack
State: New York
ZIP Code: 11725-3510
Phone: (631) 543-2338

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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