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General NPI Number Information
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NPI Number | 1942564307
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Entity Type | Individual
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Provider Name | MELISA ANDERSON M.S.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2012
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 20 CEDAR ST
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5247
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Country | US
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Telephone | 914-576-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 412 EDWARD PL
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City | MAMARONECK
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State | NY
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Zip | 10543-2901
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Country | US
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Telephone | 914-698-4622
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 00000
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License Number State |
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