Provider Demographics
NPI:1437293792
Name:GROVIT, MELVYN (DPM, MS, CNS)
Entity Type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:
Last Name:GROVIT
Suffix:
Gender:M
Credentials:DPM, MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CHANNING PL
Mailing Address - Street 2:2L
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-1033
Mailing Address - Country:US
Mailing Address - Phone:914-337-7419
Mailing Address - Fax:914-771-4040
Practice Address - Street 1:45 LUDLOW ST
Practice Address - Street 2:SUITE 618
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1947
Practice Address - Country:US
Practice Address - Phone:914-476-1544
Practice Address - Fax:914-771-4040
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000115-1133N00000X
NYN002070-1213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No133N00000XDietary & Nutritional Service ProvidersNutritionist