Provider Demographics
NPI:1922263581
Name:MELENDEZ RIOS, NYSSA ZOE (MD)
Entity Type:Individual
Prefix:DR
First Name:NYSSA
Middle Name:ZOE
Last Name:MELENDEZ RIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 MERRIMACK ST
Mailing Address - Street 2:APARTMENT # 514
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1772
Mailing Address - Country:US
Mailing Address - Phone:787-525-4184
Mailing Address - Fax:
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:LAWRENCE GENERAL HOSPITAL
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-946-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17904207R00000X
MA261249207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GQ793AOtherMEDICARE PTAN