Healthcare Provider Details

I. General information

NPI: 1427438506
Provider Name (Legal Business Name): MELISSA ABREU PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 GRAND CONCOURSE APT L3
BRONX NY
10458-1534
US

IV. Provider business mailing address

3010 GRAND CONCOURSE APT L3
BRONX NY
10458-1534
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-2433
  • Fax: 718-220-2434
Mailing address:
  • Phone: 718-220-2433
  • Fax: 718-220-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number018658
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: