Provider Demographics
NPI:1609506658
Name:DR MELISSA CORPUS, PSYCH, P.C.
Entity Type:Organization
Organization Name:DR MELISSA CORPUS, PSYCH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-634-1119
Mailing Address - Street 1:303 5TH AVE RM 1707
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6641
Mailing Address - Country:US
Mailing Address - Phone:929-270-7955
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1707
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6641
Practice Address - Country:US
Practice Address - Phone:929-270-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty