Provider Demographics
NPI:1598960106
Name:MELKONIAN, VANA (MD)
Entity Type:Individual
Prefix:
First Name:VANA
Middle Name:
Last Name:MELKONIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANA
Other - Middle Name:
Other - Last Name:CHAMLIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:134 SOUTH AVE
Mailing Address - Street 2:PEDIATRIC ASSOCIATES OF WELLESLEY
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1923
Mailing Address - Country:US
Mailing Address - Phone:781-736-0040
Mailing Address - Fax:
Practice Address - Street 1:134 SOUTH AVE
Practice Address - Street 2:PEDIATRIC ASSOCIATES OF WELLESLEY
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1923
Practice Address - Country:US
Practice Address - Phone:781-736-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-231833208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics