Provider Demographics
NPI:1427302397
Name:MELISSA A. DOFT MD PLLC
Entity type:Organization
Organization Name:MELISSA A. DOFT MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-600-4109
Mailing Address - Street 1:655 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5937
Mailing Address - Country:US
Mailing Address - Phone:212-600-4109
Mailing Address - Fax:917-591-9090
Practice Address - Street 1:655 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5937
Practice Address - Country:US
Practice Address - Phone:212-600-4109
Practice Address - Fax:917-591-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2394161261QM2500X
CT050794261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty