MEDICARE: MS. MELISSA ANN STADLER LMSW

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	1041C0700X	Clinical Social Worker	087175	NY

General Provider Information

NPI Number	:	1992322606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA ANN STADLER LMSW

Provider Business Mailing Address
First Line	:	PO BOX 612
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075-0612
Country	:	US
Telephone Number	:	716-480-2133
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 UNION ST
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075-4752
Country	:	US
Telephone Number	:	716-800-2938
Fax Number	:

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

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	02/16/2024

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