Provider Demographics
NPI:1144763061
Name:MCDONALD, MELANIE GRENALD (DPT)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:GRENALD
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:GRENALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:81 E 28TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5583
Mailing Address - Country:US
Mailing Address - Phone:347-400-5201
Mailing Address - Fax:
Practice Address - Street 1:19 W 21ST ST RM 404
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6877
Practice Address - Country:US
Practice Address - Phone:347-400-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-25
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist