Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 304848 | NY |
NPI | 1033440896 |
---|---|
Provider Name | Patricia M. Melville |
First Address | Stony Brook, NY 11790-0989 |
Second Address | East Setauket, NY 11733-3528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2010 |
Last Update Date | 19/01/2010 |