Provider Demographics
NPI:1972154698
Name:HURLEY, MELISSA MEGAN
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MEGAN
Last Name:HURLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2333
Mailing Address - Country:US
Mailing Address - Phone:716-935-0464
Mailing Address - Fax:
Practice Address - Street 1:157 TREMONT AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2333
Practice Address - Country:US
Practice Address - Phone:716-935-0464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist