Provider Demographics
NPI:1639461437
Name:FLORANTE MELCHOR MD FACP PLLC
Entity Type:Organization
Organization Name:FLORANTE MELCHOR MD FACP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLORANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELCHOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-935-1800
Mailing Address - Street 1:120 BETHPAGE RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1515
Mailing Address - Country:US
Mailing Address - Phone:516-935-1800
Mailing Address - Fax:516-935-4398
Practice Address - Street 1:120 BETHPAGE RD
Practice Address - Street 2:SUITE 305
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1515
Practice Address - Country:US
Practice Address - Phone:516-935-1800
Practice Address - Fax:516-935-4398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01243154Medicaid
NY30F461Medicare UPIN