Provider Demographics
NPI:1760211767
Name:MELISSA MERLIN, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:MELISSA MERLIN, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:716-253-1488
Mailing Address - Street 1:1902 RIDGE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3312
Mailing Address - Country:US
Mailing Address - Phone:716-207-1788
Mailing Address - Fax:
Practice Address - Street 1:187 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-1918
Practice Address - Country:US
Practice Address - Phone:716-253-1488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty