Provider Demographics
NPI:1376308569
Name:MELSHEIMER, MACKENZIE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ANN
Last Name:MELSHEIMER
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:108 ROYAL CT
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1623
Mailing Address - Country:US
Mailing Address - Phone:267-664-5585
Mailing Address - Fax:
Practice Address - Street 1:1027 46TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5245
Practice Address - Country:US
Practice Address - Phone:212-385-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant