Provider Demographics
NPI:1073211561
Name:MELENDEZ, VIRMA M
Entity Type:Individual
Prefix:
First Name:VIRMA
Middle Name:M
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 BERSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710
Mailing Address - Country:US
Mailing Address - Phone:347-405-0373
Mailing Address - Fax:
Practice Address - Street 1:173 HUGUENOT ST STE 201
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7710
Practice Address - Country:US
Practice Address - Phone:914-239-8455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator