Provider Demographics
NPI:1184645400
Name:CIECKO, MELISSA LAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LAYNE
Last Name:CIECKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N. GEORGE STREET
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440
Mailing Address - Country:US
Mailing Address - Phone:315-404-5485
Mailing Address - Fax:315-533-5037
Practice Address - Street 1:300N. GEORGE STREET
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440
Practice Address - Country:US
Practice Address - Phone:315-404-5485
Practice Address - Fax:315-533-5037
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX101018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1A0696Medicare ID - Type Unspecified