Provider Demographics
NPI:1053485516
Name:MELMAR REHAB
Entity Type:Organization
Organization Name:MELMAR REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-206-3600
Mailing Address - Street 1:PO BOX 180277
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-0277
Mailing Address - Country:US
Mailing Address - Phone:718-206-3600
Mailing Address - Fax:
Practice Address - Street 1:13402 91ST AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2801
Practice Address - Country:US
Practice Address - Phone:718-206-3600
Practice Address - Fax:718-206-4219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02214102Medicaid
NY02214102Medicaid
NYA08002569Medicare ID - Type UnspecifiedELECTRONIC BILLING ID