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NPI Code Detail

MEDICARE: MELISSA GUILLERMO MD

MEDICARE: MELISSA GUILLERMO MD
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
12080N0001XNeonatal-Perinatal Medicine Physician319242NY

General Provider Information

NPI Number : 1841505187
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA GUILLERMO MD
Provider Business Mailing Address
First Line : 355 BARD AVE RM 314
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-1699
Country : US
Telephone Number : 925-384-7761
Fax Number : 718-818-2739
Provider Business Practice Location Address
First Line : 355 BARD AVE RM 314
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-1699
Country : US
Telephone Number : 718-818-4636
Fax Number : 718-818-2739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2010
Last Update Date : 09/26/2023

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