Provider Demographics
NPI:1972624252
Name:MELE-DELGADO, MELISSA MICHELE (ANP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MICHELE
Last Name:MELE-DELGADO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MICHELE
Other - Last Name:MELE-DELGADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANP
Mailing Address - Street 1:1140 YOUNGS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8054
Mailing Address - Country:US
Mailing Address - Phone:716-688-0020
Mailing Address - Fax:
Practice Address - Street 1:1140 YOUNGS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8054
Practice Address - Country:US
Practice Address - Phone:716-688-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304593363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY304593OtherLICENSE
NYMM1555955OtherDEA