MEDICARE: ADRIANNE H MELLOS M.D.

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	207RC0000X	Cardiovascular Disease Physician	222001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275562456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANNE H MELLOS M.D.

Provider Business Mailing Address
First Line	:	44-01 FRANCIS LEWIS BOULEVARD
Second Line	:	SUITE L3A
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3002
Country	:	US
Telephone Number	:	718-423-3355
Fax Number	:	718-423-3721

Provider Business Practice Location Address
First Line	:	44-01 FRANCIS LEWIS BOULEVARD
Second Line	:	SUITE L3A
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3002
Country	:	US
Telephone Number	:	718-423-3355
Fax Number	:	718-423-3721

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	02/24/2021

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