Healthcare Provider Details

I. General information

NPI: 1811229123
Provider Name (Legal Business Name): MELISSA DIONNE ORR LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16937 144TH RD
JAMAICA NY
11434-5929
US

IV. Provider business mailing address

43 DEVON ST
MALVERNE NY
11565-2308
US

V. Phone/Fax

Practice location:
  • Phone: 718-978-7221
  • Fax: 718-978-0032
Mailing address:
  • Phone: 917-363-4842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number278637-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: