Provider Demographics
NPI:1437873882
Name:MELE, PATRICK (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MELE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:PATRICK
Other - Middle Name:EDWARD
Other - Last Name:MELE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:770 NUGENT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5455
Mailing Address - Country:US
Mailing Address - Phone:718-344-4898
Mailing Address - Fax:
Practice Address - Street 1:82 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4510
Practice Address - Country:US
Practice Address - Phone:347-403-4247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025238103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist