Doctor Name: | MS. MELISSA ACQUAVIVA |
NPI Number: | 1023083292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPA-C |
License Number: | PA9104557 |
Business Practice Address: | Stony Brook Hospital Hsc Level 19. Department Of Surgery Rm 080 Stony Brook, NY - 117940001 |
Business Phone Number: | 6314448021 |
Business Fax Number: | |
Mailing Address: | Stony Brook Hospital, Hsc Level 19. Department Of Surgery STONY BROOK |
State: | NY |
Postal Code: | 117940001 |
Phone Number: | 6314448021 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2006 |
NPI Last Update Date: | 12/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA9104557 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |