Provider Demographics
NPI:1962825190
Name:ALFONSO, MELANIE HILLENBRAND (RN)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:HILLENBRAND
Last Name:ALFONSO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:11 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1705
Mailing Address - Country:US
Mailing Address - Phone:845-360-5282
Mailing Address - Fax:845-360-5282
Practice Address - Street 1:11 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1705
Practice Address - Country:US
Practice Address - Phone:845-360-5282
Practice Address - Fax:845-360-5282
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY458270-1163WP0200X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WS0200XNursing Service ProvidersRegistered NurseSchool