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General NPI Number Information
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NPI Number | 1477371938
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Entity Type | Individual
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Provider Name | MELISSA MELILLI FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 6511 SPRING BROOK AVE STE 201
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City | RHINEBECK
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State | NY
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Zip | 12572-3709
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Country | US
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Telephone | 845-871-3108
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HOOF PRINT RD
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City | MILLBROOK
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State | NY
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Zip | 12545-6001
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Country | US
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Telephone | 845-596-6185
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 355271
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License Number State | NY
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