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General NPI Number Information
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NPI Number | 1760771893
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Entity Type | Organization
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Legal Business Name | MELINDA MINGUS MD PLLC
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 109 W 89TH ST APT 2B
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City | NEW YORK
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State | NY
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Zip | 10024-1947
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Country | US
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Telephone | 646-522-1451
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Fax |
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Provider Business Mailing Address
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Address Line | 109 W 89TH ST APT#2B
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City | NEW YORK
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State | NY
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Zip | 10024-1946
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Country | US
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Telephone | 646-522-1451
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MELINDA MINGUS
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Credential | M.D.
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Telephone | 646-522-1451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | NY
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