Provider Demographics
NPI:1457626897
Name:IAMMATTEO, MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:IAMMATTEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 HAVILAND LN
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-3033
Mailing Address - Country:US
Mailing Address - Phone:917-509-6200
Mailing Address - Fax:
Practice Address - Street 1:170 HAVILAND LN
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-3033
Practice Address - Country:US
Practice Address - Phone:914-428-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2022-06-02
Deactivation Date:2020-07-17
Deactivation Code:
Reactivation Date:2020-07-28
Provider Licenses
StateLicense IDTaxonomies
NY277818207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine