Provider Demographics
NPI:1508116831
Name:MELAMED, FRANCINE J (R-LCSW)
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:J
Last Name:MELAMED
Suffix:
Gender:F
Credentials:R-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 DITMARS BLVD
Mailing Address - Street 2:APT. B1
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1225
Mailing Address - Country:US
Mailing Address - Phone:718-932-6062
Mailing Address - Fax:
Practice Address - Street 1:1250 BROADWAY
Practice Address - Street 2:VNSNY SPARK CARE 4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3701
Practice Address - Country:US
Practice Address - Phone:212-630-5290
Practice Address - Fax:212-290-0158
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033498 11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical