CHARLES MELLOR

PORT JEFFERSON, NY
NPI1114014032
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  004335)
Enumeration Date2006-10-10
Last Update Date2015-10-22
Business Address
-- CHARLES MELLOR PA
75 N COUNTRY RD
PORT JEFFERSON, NY 11777-2119
Phone number: 631-473-1320
Mailing Address
-- CHARLES MELLOR PA
75 N COUNTRY RD
PORT JEFFERSON, NY 11777-2119
Phone number: 631-473-1320
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