Healthcare Provider Details

I. General information

NPI: 1497701965
Provider Name (Legal Business Name): LUIS MELGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4893 TRANSIT RD STE 3
DEPEW NY
14043-4698
US

IV. Provider business mailing address

PO BOX 8000
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 716-608-7040
  • Fax: 716-608-7065
Mailing address:
  • Phone: 716-852-4772
  • Fax: 716-608-7065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number190379
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number190379
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: