MEDICARE: GILLIAN KATHLEEN MELIKIAN PA-C

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	363A00000X	Physician Assistant		MA

General Provider Information

NPI Number	:	1902659584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILLIAN KATHLEEN MELIKIAN PA-C

Provider Business Mailing Address
First Line	:	775 DAVOL ST STE 300
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-1028
Country	:	US
Telephone Number	:	508-674-4000
Fax Number	:	508-674-8880

Provider Business Practice Location Address
First Line	:	1526 ATWOOD AVE STE 220
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-3289
Country	:	US
Telephone Number	:	401-396-2227
Fax Number	:	401-421-1120

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

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	01/15/2026

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