Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Mellor, PA

Individual provider Physician Assistant · NPI 1114014032

Charles Mellor, PA is a Physician Assistant in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone: (631) 473-1320
Fax: (631) 686-7653
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 004335 (NY)

Record details

NPI number1114014032
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 10, 2006
Last updated in NPPESOctober 22, 2015

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