Provider Demographics
NPI:1477976934
Name:WOLBRANSKY, MELINDA (PHD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:WOLBRANSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 BROADWAY
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7616
Mailing Address - Country:US
Mailing Address - Phone:718-534-0689
Mailing Address - Fax:516-430-5031
Practice Address - Street 1:445 CENTRAL AVE
Practice Address - Street 2:SUITE 345
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2001
Practice Address - Country:US
Practice Address - Phone:718-534-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020246103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical