Individual ProviderMelissa Anne PiskozubNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907(703) 295-9360(516) 945-3000PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Anne Piskozub does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1992048409Provider TypeIndividualFull NamePiskozub, Melissa AnneTitleMs.CredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date4/3/2013Last Updated3/13/2015Contact InformationPractice LocationPractice Address3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907Phone(703) 295-9360Fax(703) 295-9369Mailing LocationMailing Address68 South Service Road, Suite 350, Melville, NY 11747-3090Phone(516) 945-3000Fax(516) 945-3131Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024171249VirginiaCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR199524MarylandProvider IdentifiersIDDescriptionIssuerIDPENDINGDescriptionMedicaidIssuerUnlistedVirginia