Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 303275 | NY |
NPI | 1043664550 |
---|---|
Provider Name | Dr. Melissa Lectura |
First Address | Stony Brook, NY 11790-0989 |
Second Address | East Setauket, NY 11733-3483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2016 |
Last Update Date | 07/05/2020 |