Provider Demographics
NPI:1689833212
Name:VEINO, MELISSA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:VEINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:REITTINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4 NORMANSKILL BLVD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1335
Mailing Address - Country:US
Mailing Address - Phone:518-478-9423
Mailing Address - Fax:518-439-7046
Practice Address - Street 1:4 NORMANSKILL BLVD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1335
Practice Address - Country:US
Practice Address - Phone:518-478-9423
Practice Address - Fax:518-439-7046
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262506208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03379884Medicaid
NYJ400058222Medicare PIN