Active NPI
Renae Mellerski
- Student in an Organized Health Care Education/Training Program
- New York, NY
National Provider Identifier
1669293577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 68-P131455-01
- Practice address
- 2248 Broadway # 1440
New York, NY 10024-5805 - Phone
- (717) 475-6550
- NPI assigned
- Oct 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 68-P131455-01 | NY | Primary |
Addresses
Primary practice location
2248 Broadway # 1440
New York, NY 10024-5805
Mailing address
6784 Milestrip Rd
Orchard Park, NY 14127-1668
Phone (717) 475-6550
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68-P131455-01 | NY | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1669293577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6784 MILESTRIP RD",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141271668",
"telephone_number": "717-475-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2248 BROADWAY # 1440",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100245805",
"telephone_number": "717-475-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLERSKI",
"first_name": "RENAE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-23",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "68-P131455-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.