Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 009175 | NY |
NPI | 1437402195 |
---|---|
Provider Name | Dr. Robert Melo |
First Address | Howard Beach, NY 11414-2501 |
Second Address | Howard Beach, NY 11414-2501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2012 |
Last Update Date | 18/10/2012 |