Healthcare Provider Details

I. General information

NPI: 1841137981
Provider Name (Legal Business Name): MELANIE CRISOL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CORPORATE BLVD S
YONKERS NY
10701-6862
US

IV. Provider business mailing address

1948 PAULDING AVE
BRONX NY
10462-3130
US

V. Phone/Fax

Practice location:
  • Phone: 914-597-2500
  • Fax:
Mailing address:
  • Phone: 646-531-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number984624
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: