MEDICARE: MS. MELISSA ERICA MARLIEB PHARMD

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	183500000X	Pharmacist	053858	NY

General Provider Information

NPI Number	:	1225350036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA ERICA MARLIEB PHARMD

Provider Business Mailing Address
First Line	:	9602 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-1613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9602 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-1613
Country	:	US
Telephone Number	:	718-848-2334
Fax Number	:

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

Provider Enumeration Date	:	02/20/2010
Last Update Date	:	01/26/2011

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