Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F305778-1 | NY |
N | 363LG0600X | Nurse Practitioner - Gerontology | F340825-1 | NY |
NPI | 1033545314 |
---|---|
Provider Name | Melissa Clemente |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2013 |
Last Update Date | 09/03/2021 |