Provider Demographics
NPI:1326692369
Name:MELENDEZ, GREKCHY N (DO)
Entity Type:Individual
Prefix:
First Name:GREKCHY
Middle Name:N
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:AGUIRRE
Mailing Address - State:PR
Mailing Address - Zip Code:00704-0312
Mailing Address - Country:US
Mailing Address - Phone:787-636-6722
Mailing Address - Fax:
Practice Address - Street 1:122 CALLE URAYOAN
Practice Address - Street 2:URB CUIDAD JARDIN JUNCOS
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-4616
Practice Address - Country:US
Practice Address - Phone:787-636-6722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3906Medicaid