Provider Demographics
NPI:1144563800
Name:HARNSBERGER, MELISSA ANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:HARNSBERGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:KORKMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1000 E GENESEE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1853
Mailing Address - Country:US
Mailing Address - Phone:315-471-1044
Mailing Address - Fax:
Practice Address - Street 1:1000 E GENESEE ST STE 300
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1853
Practice Address - Country:US
Practice Address - Phone:315-471-1044
Practice Address - Fax:315-474-4312
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-003992363A00000X
ALPA-929363A00000X
NY021071-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant