Provider Demographics
NPI:1346290848
Name:ONYSKO, MELODYE ELAINE (NP/CNM)
Entity Type:Individual
Prefix:
First Name:MELODYE
Middle Name:ELAINE
Last Name:ONYSKO
Suffix:
Gender:F
Credentials:NP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2065
Mailing Address - Country:US
Mailing Address - Phone:607-754-9870
Mailing Address - Fax:607-785-9862
Practice Address - Street 1:401 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2065
Practice Address - Country:US
Practice Address - Phone:607-754-9870
Practice Address - Fax:607-785-9862
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000825367A00000X
NYF302062363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01992263Medicaid
S95926Medicare UPIN
NYCC3804Medicare ID - Type Unspecified
NY01992263Medicaid
NYRB6630Medicare PIN