Provider Demographics
NPI:1073541371
Name:MELNICK, HOWARD BERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:BERMAN
Last Name:MELNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 RUSSELL DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7487
Mailing Address - Country:US
Mailing Address - Phone:717-274-9775
Mailing Address - Fax:717-274-9894
Practice Address - Street 1:927 RUSSELL DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7487
Practice Address - Country:US
Practice Address - Phone:717-274-9775
Practice Address - Fax:717-274-9894
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029708E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1083920Medicaid
PA1083920Medicaid
PAB36589Medicare UPIN