Provider Demographics
NPI:1992700934
Name:MELLO, KAREN A (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:MELLO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:500 MERRIMACK ST
Mailing Address - Street 2:RIVERWALK
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1756
Mailing Address - Country:US
Mailing Address - Phone:978-557-8900
Mailing Address - Fax:978-557-8859
Practice Address - Street 1:500 MERRIMACK ST
Practice Address - Street 2:RIVERWALK
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1756
Practice Address - Country:US
Practice Address - Phone:978-557-8900
Practice Address - Fax:978-557-8859
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2012-11-19
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Provider Licenses
StateLicense IDTaxonomies
MA53983207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
92-00140OtherEVERCARE
0011275OtherNEIGHBORHOOD HEALTH PLAN
MA6198066Medicaid
9765855OtherNETWORK HEALTH
MA053983OtherTUFTS HEALTH PLAN
NH30004119OtherNH MEDICAID
NHA57670OtherANTHEM BLUE CROSS
MA61903OtherHARVARD PILGRIM HEALTHCAR
MDJ04378OtherBLUE CROSS BLUE SHIELD
MA1992700934OtherFALLON COMMUNITY HEALTH PLAN
678810OtherHEALTHSOURCE
MA110066143AMedicaid
110214702OtherRAILROAD MEDICARE
1750172OtherCIGNA HEALTHCARE
110214702OtherRAILROAD MEDICARE
MDJ04378OtherBLUE CROSS BLUE SHIELD