Provider Demographics
NPI:1891592333
Name:BERNABE, MELODY GARCIA (NP)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:GARCIA
Last Name:BERNABE
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:ANASTACIO
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:51 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-2313
Mailing Address - Country:US
Mailing Address - Phone:516-395-5624
Mailing Address - Fax:
Practice Address - Street 1:51 YORK ST
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-2313
Practice Address - Country:US
Practice Address - Phone:516-395-5624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312057363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health