Healthcare Provider Details

I. General information

NPI: 1932031440
Provider Name (Legal Business Name): MELISSA METZLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 CHILI AVE STE 5
ROCHESTER NY
14624-3334
US

IV. Provider business mailing address

138 BREBEUF DR APT D
PENFIELD NY
14526-2123
US

V. Phone/Fax

Practice location:
  • Phone: 585-406-3151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number102314
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: