Provider Demographics
NPI:1366488009
Name:MELNIKER, LAWRENCE ARON (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ARON
Last Name:MELNIKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3609
Mailing Address - Country:US
Mailing Address - Phone:718-780-3424
Mailing Address - Fax:
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:THE METHODIST HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-780-3159
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178494207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01150747Medicaid
E48834Medicare UPIN
NY50F002Medicare ID - Type Unspecified