Provider Demographics
NPI:1699974121
Name:MELIS, MARCOVALERIO (MD)
Entity type:Individual
Prefix:
First Name:MARCOVALERIO
Middle Name:
Last Name:MELIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 MAIN ST
Mailing Address - Street 2:APT PH2F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0353
Mailing Address - Country:US
Mailing Address - Phone:773-936-2557
Mailing Address - Fax:
Practice Address - Street 1:415 MAIN ST
Practice Address - Street 2:APT PH2F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0353
Practice Address - Country:US
Practice Address - Phone:773-936-2557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-14
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME975882086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology