Healthcare Provider Details

I. General information

NPI: 1164051447
Provider Name (Legal Business Name): MELISSA PAIGE NOTIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 YORK AVE
NEW YORK NY
10065-4805
US

IV. Provider business mailing address

1300 YORK AVE
NEW YORK NY
10065-4805
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-4480
  • Fax:
Mailing address:
  • Phone: 212-746-4480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number346423-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: