Provider / Organization | NPI | Date Certified |
---|---|---|
MELISSA R DEZAN | 1346609773 | 2023-01-21 |
Melissa R Dezan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1346609773. Registration indicates Melissa R Dezan is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse, ) (All Other Specialties & Provider Types, ) (Registered Nurse, Nursing Service Providers) (Nursing Service Providers, Licensed Practical Nurse) (Licensed Practical Nurse, ) (Licensed Practical Nurse, Nursing Service Providers) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
Entity Type | Individual |
Provider Name | Miss Melissa R Dezan MS, FNP-BC |
Other Provider Name | Ms. Melissa R Dezan |
Practice Office Address | 7925 WINCHESTER BLVD QUEENS VILLAGE, NY US |
Practice Office Telephone | 7184647500 |
Mailing Address | 1434 ALPHA ST ELMONT, NY 110032403 US |
Address | City / State | Phone / Fax |
---|---|---|
1434 Alpha St | Elmont, NY 110032403 | 0000000003 |
Code | Practice | License No State |
---|---|---|
163W00000X | Nursing Service Providers Registered Nurse Registered Nurse All Other Specialties & Provider Types Registered Nurse Nursing Service Providers | 726454
NY |
164W00000X | Nursing Service Providers Licensed Practical Nurse Licensed Practical Nurse Licensed Practical Nurse Nursing Service Providers | 3209241
NY |
363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 350891
NY |