Provider Demographics
NPI:1255925442
Name:LOSS, MELANIE GRANIERI
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:GRANIERI
Last Name:LOSS
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 1:29 SAWMILL RUN
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1866
Mailing Address - Country:US
Mailing Address - Phone:716-697-3252
Mailing Address - Fax:
Practice Address - Street 1:29 SAWMILL RUN
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1866
Practice Address - Country:US
Practice Address - Phone:716-697-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407583-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse