Charles Mellor, PA
NPI #1114014032 in Port Jefferson, New York
Provider Information
- NPI Number
- 1114014032
- Entity Type
- Individual
- Name
- Charles Mellor, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Oct 10, 2006
- Last Updated
- Oct 22, 2015
Practice Location
- Address
- 75 N COUNTRY RD
- City
- Port Jefferson
- State
- New York
- ZIP Code
- 11777-2119
- Phone
- (631) 473-1320
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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