Provider Demographics
NPI:1760235279
Name:ZIEGLER, MELISSA LAUREN (MA ECE SPED)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LAUREN
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:MA ECE SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 KNOLLCREST RD
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2810
Mailing Address - Country:US
Mailing Address - Phone:631-316-2006
Mailing Address - Fax:
Practice Address - Street 1:80 ORVILLE DR STE 10010185
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2534
Practice Address - Country:US
Practice Address - Phone:631-385-7780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1639723221174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist