Provider Demographics
NPI:1881740215
Name:MELUCCI, MARYANN E (CRNA)
Entity type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:E
Last Name:MELUCCI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:MARYANN
Other - Middle Name:E
Other - Last Name:BARRANCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:31 OLD FARM HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1147
Mailing Address - Country:US
Mailing Address - Phone:203-364-1495
Mailing Address - Fax:
Practice Address - Street 1:333 ROUTE 25A
Practice Address - Street 2:SUITE 225
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778
Practice Address - Country:US
Practice Address - Phone:631-744-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY49505367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered