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General NPI Number Information
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NPI Number | 1023090420
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Entity Type | Individual
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Provider Name | MELISSA A MCCRACKEN OD
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Gender | Female
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Dates
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Enumeration Date | 11/19/2005
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Last Update Date | 03/26/2022
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Provider Practice Location Address
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Address Line | 27 PORTER AVE
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City | JAMESTOWN
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State | NY
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Zip | 14701
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Country | US
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Telephone | 716-483-2020
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Fax | 716-488-9295
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Provider Business Mailing Address
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Address Line | 27 PORTER AVE
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City | JAMESTOWN
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State | NY
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Zip | 14701
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Country | US
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Telephone | 716-483-2020
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Fax | 716-488-9295
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007263-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001485
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007263
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG1485
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License Number State | PA
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