Provider Demographics
NPI:1740859578
Name:KEEFE, MELISSA
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:KEEFE
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 1:12125 COUNTYLINE RD
Mailing Address - Street 2:
Mailing Address - City:YORKSHIRE
Mailing Address - State:NY
Mailing Address - Zip Code:14173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12125 COUNTYLINE RD
Practice Address - Street 2:
Practice Address - City:YORKSHIRE
Practice Address - State:NY
Practice Address - Zip Code:14173
Practice Address - Country:US
Practice Address - Phone:716-492-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist