Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 249773 | NY |
NPI | 1003078619 |
---|---|
Provider Name | Melissa S Devlin |
First Address | Great Neck, NY 11021-5334 |
Second Address | Great Neck, NY 11021-5334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 01/04/2014 |