Provider Demographics
NPI:1699832469
Name:MONTEMAYOR, MELANIE MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:MICHELLE
Last Name:MONTEMAYOR
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Gender:F
Credentials:MD
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Mailing Address - Street 1:12 RAYMOND AVE
Mailing Address - Street 2:RADIOLOGY ASSOCIATES OF POUGHKEEPSIE
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2354
Mailing Address - Country:US
Mailing Address - Phone:845-471-5519
Mailing Address - Fax:845-471-2928
Practice Address - Street 1:241 NORTH RD
Practice Address - Street 2:RADIOLOGY ASSOCIATES OF POUGHKEEPSIE
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1154
Practice Address - Country:US
Practice Address - Phone:845-471-5519
Practice Address - Fax:845-471-2928
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-08-19
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Provider Licenses
StateLicense IDTaxonomies
NY19412312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8270406Medicaid
NJ8270406Medicaid
NJ035930Medicare ID - Type Unspecified