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General NPI Number Information
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NPI Number | 1215703400
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Entity Type | Individual
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Provider Name | MELISSA MIKSITS DPT
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Gender | Female
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 401 HAWTHORNE LN STE 101-319
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City | CHARLOTTE
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State | NC
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Zip | 28204-2484
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Country | US
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Telephone | 516-417-7362
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Fax |
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Provider Business Mailing Address
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Address Line | 2697 BEDELL ST
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City | BELLMORE
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State | NY
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Zip | 11710-4647
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P22663
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14463
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05035601
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License Number State | NY
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