Provider Demographics
NPI:1285984203
Name:SCHWAB, MELISSA M
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8777 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GASPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14067-9414
Mailing Address - Country:US
Mailing Address - Phone:716-912-4925
Mailing Address - Fax:
Practice Address - Street 1:8777 RIDGE RD
Practice Address - Street 2:
Practice Address - City:GASPORT
Practice Address - State:NY
Practice Address - Zip Code:14067-9414
Practice Address - Country:US
Practice Address - Phone:716-912-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist