Most Relevant Information
Provider Data
| NPI Number: | 1003518960 |
| Provider Name: | JUSTINA CATHERINE MELLONE DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/21/2023 |
| Last Updated: | 03/21/2023 |
Provider Practice Location
75 N COUNTRY RD
PORT JEFFERSON
NY
117772190
Practice Location Phone/Fax
| Phone: | 6314731320 |
| Fax: |
Provider Mailing Location
75 N COUNTRY RD
PORT JEFFERSON
NY
117772119
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |