Provider Demographics
NPI:1427303353
Name:BENARDOT, MELISSA J (CPNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:BENARDOT
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Gender:F
Credentials:CPNP
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Mailing Address - Street 1:4 COMMERCE LANE
Mailing Address - Street 2:COMMUNITY HEALTH CENTER
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617
Mailing Address - Country:US
Mailing Address - Phone:315-386-8191
Mailing Address - Fax:315-386-1410
Practice Address - Street 1:380 CTY RT 57
Practice Address - Street 2:COMMUNITY HEALTH CENTER
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953
Practice Address - Country:US
Practice Address - Phone:518-483-0109
Practice Address - Fax:518-483-0115
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2024-05-01
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Provider Licenses
StateLicense IDTaxonomies
NY382304363LP0200X
NY344053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics