Healthcare Provider Details

I. General information

NPI: 1033420120
Provider Name (Legal Business Name): MELISSA A MERLIN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 RIDGE RD STE 150
WEST SENECA NY
14224-3312
US

IV. Provider business mailing address

1902 RIDGE RD STE 150
WEST SENECA NY
14224-3312
US

V. Phone/Fax

Practice location:
  • Phone: 716-253-1488
  • Fax: 937-889-2952
Mailing address:
  • Phone: 716-253-1488
  • Fax: 937-889-2952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number401284
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: