Individual provider Active NPI

Jennifer Kuhl Melillo

  • Specialist
  • Staten Island, NY
National Provider Identifier
1609474352
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2511999 Issued in NY
Practice address
22 Watkins Ave
Staten Island, NY 10312-1521
Phone
(929) 284-4147
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2511999 NY Primary

Addresses

Primary practice location

22 Watkins Ave
Staten Island, NY 10312-1521

Mailing address

22 Watkins Ave
Staten Island, NY 10312-1521

Other names 1

  • Jennifer Kuhl Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2511999NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1609474352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WATKINS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WATKINS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121521",
            "telephone_number": "929-284-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUHL MELILLO",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2511999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KUHL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.