Melissa Elaine Kotary, LPN

Individual provider Active NPI Licensed Practical Nurse · Canastota, NY

NPI 1780915843 · NPPES record last updated Jan 28, 2010

Key facts

NPI
1780915843
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
299337-1 (NY)
Practice address
3462 Conifer Dr Apt 30
Canastota, NY 13032-4788
Phone
(315) 281-7515
NPI assigned
Jan 28, 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
299337-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 299337-1 NY Yes

Addresses

Primary practice location

3462 Conifer Dr Apt 30
Canastota, NY 13032-4788

Mailing address

3462 Conifer Dr Apt 30
Canastota, NY 13032-4788
Phone (315) 281-7515

Other providers in Canastota, NY

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

Sources for this page

Verify at the official NPI Registry.