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General NPI Number Information
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NPI Number | 1770409476
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Entity Type | Individual
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Provider Name | SOPHIA NICOLE MELLY CGC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 173 FORT WASHINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10032-3739
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Country | US
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Telephone | 347-346-0685
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Fax | 646-967-4295
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Provider Business Mailing Address
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Address Line | 173 FORT WASHINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10032-3739
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Country | US
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Telephone | 347-346-0685
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Fax | 646-967-4295
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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 | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | 22715
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License Number State | NY
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