Mellish, Diane Lynne

Mellish, Diane Lynne is an sole proprietor health care provider with primary practice located at 22 S Ketcham Ave , Amityville NY 11701-3520. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Mellish, Diane Lynne can be contacted via phone (631) 598-0094.

Contact Information

Primary practice address
22 S Ketcham Ave Amityville NY 11701-3520
Phone: (631) 598-0094
Fax: (631) 598-0094
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 335681-1 New York

Profile Details

NPI number 1063582310
LBN Legal business name Mellish, Diane Lynne
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 8th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063582310 NPPES
New York MEDICAID 01412000

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