Provider Demographics
NPI:1790308716
Name:FIGUEROA, MELODY
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 WOODBRIDGE DR W
Mailing Address - Street 2:
Mailing Address - City:BUSHKILL
Mailing Address - State:PA
Mailing Address - Zip Code:18324-7015
Mailing Address - Country:US
Mailing Address - Phone:201-988-3971
Mailing Address - Fax:
Practice Address - Street 1:327 BEACH 19TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4423
Practice Address - Country:US
Practice Address - Phone:718-869-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY655153163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse