Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 107813 | NY |
NPI | 1205942786 |
---|---|
Provider Name | Charles P Melone JR. |
First Address | Massapequa Park, NY 11762-0270 |
Second Address | New York, NY 10016-4942 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 20/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C08165 | (02) |