MEDICARE: IM CARE FAMILY HEALTH NP PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1003501826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IM CARE FAMILY HEALTH NP PC

Provider Business Mailing Address
First Line	:	78 LONGVIEW RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-1712
Country	:	US
Telephone Number	:	718-864-8208
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 LONGVIEW RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-1712
Country	:	US
Telephone Number	:	718-864-8208
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	INGA MELNIKOVA
Credential	:	NP
Telephone Number	:	718-864-8208

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	10/24/2025

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