Provider Demographics
NPI:1164448767
Name:HOWARD B MELNICK MD PC
Entity Type:Organization
Organization Name:HOWARD B MELNICK MD PC
Other - Org Name:MELNICK, MOFFITT & MESAROS ENT ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:WALEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-274-9775
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA846303Medicare ID - Type UnspecifiedGROUP NUMBER