Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 045310 | NY |
NPI | 1013936426 |
---|---|
Provider Name | Dr. John P Melinski |
First Address | Merrick, NY 11566-4532 |
Second Address | Merrick, NY 11566-4532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |