Provider Demographics
NPI:1295397420
Name:MELENDEZ, ARLENE
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
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 1:820 COLGATE AVE
Mailing Address - Street 2:1J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4821
Mailing Address - Country:US
Mailing Address - Phone:646-898-5644
Mailing Address - Fax:
Practice Address - Street 1:820 COLGATE AVE APT 1J
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4821
Practice Address - Country:US
Practice Address - Phone:646-898-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003520208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation