Provider Demographics
NPI:1669498242
Name:CATTELL, MELE (PA)
Entity Type:Individual
Prefix:
First Name:MELE
Middle Name:
Last Name:CATTELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 NORTH RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1172
Mailing Address - Country:US
Mailing Address - Phone:845-451-7251
Mailing Address - Fax:845-451-7757
Practice Address - Street 1:1 WEBSTER AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1361
Practice Address - Country:US
Practice Address - Phone:845-483-5858
Practice Address - Fax:845-451-7757
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003764363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS24145Medicare UPIN