Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 232566 | NY |
NPI | 1104925833 |
---|---|
Provider Name | Renee S Melfi |
First Address | East Syracuse, NY 13057-3081 |
Second Address | East Syracuse, NY 13057-3081 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 05/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02621438 | (05) | NY |
J400058169 | (02) | NY |