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General NPI Number Information
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NPI Number | 1255083101
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Entity Type | Individual
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Provider Name | MELISSA ANN CALANDRELLA
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Gender | Female
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 200 COMMUNITY DR
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City | GREAT NECK
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State | NY
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Zip | 11021-5510
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Country | US
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Telephone | 516-414-3900
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Fax | 516-414-3891
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Provider Business Mailing Address
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Address Line | 24524A 76TH AVE
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City | BELLEROSE
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State | NY
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Zip | 11426-1867
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Country | US
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Telephone | 917-375-7401
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 048295
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License Number State | NY
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