Melissa Renee Bouvia

Individual provider Active NPI Licensed Practical Nurse · Baldwinsville, NY

NPI 1477864965 · NPPES record last updated Jun 29, 2010

Key facts

NPI
1477864965
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
270742-1 (NY)
Practice address
3671 Gaskin Rd
Baldwinsville, NY 13027-9322
Phone
(315) 657-8261
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
270742-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 270742-1 NY Yes

Addresses

Primary practice location

3671 Gaskin Rd
Baldwinsville, NY 13027-9322

Mailing address

3671 Gaskin Rd
Baldwinsville, NY 13027-9322
Phone (315) 657-8261

Other providers in Baldwinsville, NY

All providers in Baldwinsville, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.