Provider Demographics
NPI:1619931631
Name:O'LOUGHLIN, MELISSA SCALZI (DC)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:SCALZI
Last Name:O'LOUGHLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 OLD FORGE LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4134
Mailing Address - Country:US
Mailing Address - Phone:585-729-9846
Mailing Address - Fax:585-394-0454
Practice Address - Street 1:23 COACH ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1529
Practice Address - Country:US
Practice Address - Phone:585-394-2030
Practice Address - Fax:585-394-0454
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011227-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010011227OtherEXCELLUS BLUECHOICE
NYC11227-8WOtherWORKER'S COMP. BOARD