Healthcare Provider Details

I. General information

NPI: 1124471669
Provider Name (Legal Business Name): MELISSA MARIE KUZO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA MARIE DEBELLO OD

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 WHITEFORD RD STE 6
YORK PA
17402-7625
US

IV. Provider business mailing address

2820 WHITEFORD RD STE 6
YORK PA
17402-7625
US

V. Phone/Fax

Practice location:
  • Phone: 717-470-0650
  • Fax: 717-470-0655
Mailing address:
  • Phone: 717-470-0650
  • Fax: 717-470-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG003168
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: