Provider Demographics
NPI:1669678736
Name:PRICE, MELISSA ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ALLISON
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ALLISON
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 MERRITT BOULEVARD- MOUNT KISCO MEDICAL GROUP
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2990
Mailing Address - Country:US
Mailing Address - Phone:845-765-4990
Mailing Address - Fax:845-765-4981
Practice Address - Street 1:60 MERRITT BOULEVARD- MOUNT KISCO MEDICAL GROUP
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2990
Practice Address - Country:US
Practice Address - Phone:845-765-4990
Practice Address - Fax:845-765-4981
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY252132207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03349979Medicaid
NYA400051736Medicare PIN