WAGNER MELLO PRIMARY CARE LLC

ROCKVILLE CENTRE, NY
NPI1568171882
Entity TypeOrganization
Authorized ContactWAGNER MELLO
Owner
631-404-7073
Organization Subpart ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
Enumeration Date2022-11-15
Last Update Date2022-11-15
Business Address
WAGNER MELLO PRIMARY CARE LLC
450 SUNRISE HWY
ROCKVILLE CENTRE, NY 11570-5053
Phone number: 631-404-7073
Mailing Address
WAGNER MELLO PRIMARY CARE LLC
610 W 150TH ST APT 3G
NEW YORK, NY 10031-2414
Phone number: 631-404-7073
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