Individual provider · Type 1 NPI

Melissa Liebold, PA-C

Physician Assistant · Port Jefferson Station, NY

NPI number 1235725672 Active

Practice location

1500 Route 112 Ste A
Port Jefferson Station, NY 11776-8055

Call (631) 265-4200 Map

Mailing address

91 Dorchester Rd
Lake Ronkonkoma, NY 11779-1616

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Physician Assistant Primary 363A00000X026336 (NY)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1235725672

Melissa Liebold, PA-C's National Provider Identifier is 1235725672, issued on Dec 20, 2020. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Mar 1, 2024.