Provider Demographics
NPI:1518175371
Name:ROY, MELVIN PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:PAUL
Last Name:ROY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2181
Mailing Address - Country:US
Mailing Address - Phone:203-865-8277
Mailing Address - Fax:203-752-9334
Practice Address - Street 1:400 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2181
Practice Address - Country:US
Practice Address - Phone:203-865-8277
Practice Address - Fax:203-752-9334
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT403103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist