Provider Demographics
NPI:1205304219
Name:GERMANO, MELISSA E (LAC)
Entity type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:E
Last Name:GERMANO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 SEA VIEW LANE
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1214
Mailing Address - Country:US
Mailing Address - Phone:631-338-7278
Mailing Address - Fax:
Practice Address - Street 1:5225 NESCONSET HIGHWAY RTE 347
Practice Address - Street 2:DAVIS PROFESSIONAL PARK BUILDING 1 SUITE 1
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776
Practice Address - Country:US
Practice Address - Phone:631-338-7278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005112171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist