Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 401284 | NY |
NPI | 1033420120 |
---|---|
Provider Name | Melissa A Merlin |
First Address | Buffalo, NY 14222-1353 |
Second Address | Buffalo, NY 14215-2814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 23/06/2010 |