Provider Demographics
NPI:1689835894
Name:UNGEHEUER, MELISSA INES (DO)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:INES
Last Name:UNGEHEUER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2629
Mailing Address - Country:US
Mailing Address - Phone:607-432-5600
Mailing Address - Fax:
Practice Address - Street 1:1 FOXCARE DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2099
Practice Address - Country:US
Practice Address - Phone:607-432-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261536208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics