MEDICARE: MRS. MELISSA ANN BIAMONTE OT REGISTERED

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	171W00000X	Contractor	011905	NY

General Provider Information

NPI Number	:	1033257449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA ANN BIAMONTE OT REGISTERED

Provider Business Mailing Address
First Line	:	5 COBBLESTONE LN
Second Line	:
City	:	LAKE GROVE
State	:	NY
Zip	:	11755-2757
Country	:	US
Telephone Number	:	631-648-8812
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 COBBLESTONE LN
Second Line	:
City	:	LAKE GROVE
State	:	NY
Zip	:	11755-2757
Country	:	US
Telephone Number	:	516-749-5759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	08/18/2011

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