Provider Demographics
NPI:1962737130
Name:MEJIA, MELINA (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:MELINA
Middle Name:
Last Name:MEJIA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W 171ST ST APT A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2818
Mailing Address - Country:US
Mailing Address - Phone:212-927-3232
Mailing Address - Fax:212-927-4573
Practice Address - Street 1:707 W 171ST ST APT A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2818
Practice Address - Country:US
Practice Address - Phone:212-927-3232
Practice Address - Fax:212-927-4573
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012392363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical